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Mucosal Carcinomas of the Esophagus―Their Subclassification of Depth of Invasion, Histologic Risk Factors and Macroscopic Features Satoru Nakagawa 1 , Hidenobu Watanabe 1 1The First Department of Pathology, Niigata University School of Medicine Keyword: 早期食道癌 , 食道粘膜癌 , 粘膜癌の深達度亜分類 , 肉眼型 , 粘膜切除の適応 pp.273-288
Published Date 1994/3/25
DOI https://doi.org/10.11477/mf.1403105750
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 We studied 181 lesions of superficial squamous cell carcinoma of the esophagus (mucosal ca. 28 cases, 135 lesions and submucosal ca. 45 cases, 46 lesions) to evaluate histological risk factors (lymphatic and venous permeations, and lymph node metastasis), and macroscopic differentiation by subclassified depth (m1, m2, m3, and sm1, sm2, sm3) of their invasion, and by invasive pattern (expansive or infiltrative).

 Carcinomas of m1 and m2 invasion revealed neither vessel permeation nor lymph node metastasis. One of 13 m3 carcinomas (7.7%) showed lymphatic permeation and another (7.7%) had venous permeation, both being infiltrative in growth pattern, but no lymph node metastasis were present in all of the 13 tumors.

 Twenty eight of 29 0-Ⅰ type carcinomas (97%) and all of 2 0-Ⅲ type carcinomas were submucosal carcinomas and all of 66 0-Ⅱb type carcinomas or 0-Ⅱb areas of combined type carcinomas were mucosal ones. Thirty of 41 0-Ⅱa type (part) (73%) and 38 of 43 0-Ⅱc type (part) (88%) limited to the mucosa. The pure 0-Ⅱa or 0-Ⅱc type carcinomas had no correlation between size and sm invasion, but the 0-Ⅱa part which was more than 5 mm in size in combined type showed a significant incidence of sm invasion.

 We assume that m1 or m2 carcinomas and m3 carcinomas with expansive growth are indication for endoscopic mucosal resection. After diagnostic mucosal resection, the lesion should be carefully examined whether it is m-carcinoma or sm1 carcinoma (surgical resection is necessary for sm1 carcinoma), and whether it is m3 carcinoma with ly(+), or v(+), or infiltrative (which requires surgical resection).


Copyright © 1994, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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