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Macroscopic Features of Submucosal Invasive Colorectal Cancers Masahikro Ikegami 1 , Tadakazu Shimoda 2 , Tosahikazu Komaki 3 , Haruhisa Kuroda 1 1Department of Pathology, The Jrkei University School of Medicine 2Division of Pathology, Clinical Laboratory, National Cancer Center Central Hospital 3Foundation for Detection of Early Gastric Carcinoma Keyword: 大腸癌 , sm癌 , 浸潤度 , 表面型大腸癌 pp.1237-1247
Published Date 1994/11/25
DOI https://doi.org/10.11477/mf.1403105964
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 To find an association between macroscopic and microscopic findings, 141 cases of resected submucosal invasive cancer of the colorectum were studied. They were classified into two groups based on cross-section view, polypoid growth(PG) and non polypoid growth (NPG). 90 lesions(63.8%)werePG, while 51 lesions (36.2%)were NPG. NPG were smaller than PG in mean size, 12.9mm and 22.5mm respectively at the intramucosal part.

 In PG, tumor size or surface irregularity suggested the existence of submucosal invasion but had no effectiveness to decide invation depth.In addition to this, deep depression or ulceration proved to be a direct indication of moderate(sm2)or severe (sm3)submucosal invasion. In PG, the depth of submucosal invasion was decided according the macroscopic appearance in each case. Superficial type PG showed moderate or severe submucosal invasion even when small in size (about 10mm)and almost all pedunculated lesions showed mild (sm1)invasion.

 NPG were considered to drive from superficial type cancers. NPG, even less than 5 mm in size, showed severe submucosal invasion so often that we must consider then to have potentially every depth of submucosal invasion. In NPG, extrusion or elevation of marginal mucosa was thought to be a direct indication of mild to severe invasion. UIceration, surface irregularity, intralesional small nodes, or fold convergence usually indicated moderate to severe submucosal invasion. There's no definite difference between intramucosal and minimal invasive cancer(sm1a)in macroscopic appearance, but the lesions showing depression were thought to be important sign of the initial change that leads to submucosal invasion.


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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