Follow-up Examination of Colo-rectal Superficial Neoplasms Kenji Maenou 1 , Mikihiro Fujiya 1 1Foundation for Detecion of Early Gastric Carcinoma Keyword: 表面型大腸腫瘍 , 経過観察 pp.523-531
Published Date 1993/5/25
DOI https://doi.org/10.11477/mf.1403106164
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 The results of follow-up examination given to 337 cases to which endoscopic mucosal resection was performed in the period from January 1980 to October 1992 were studied, especially on neoplasms grown after the endoscopic resection. And, co-existent lesion of 192 superficial colo-rectal tumors and demonstrability of these lesions of routine x-ray examination done in the same period were also analyzed. Results of this study are as follows:

 (1) Detectability of cancer is almost the same in the follow-up period in spite of the numbers of formerly resected lesion, single or multiple, and of the pathological diagnosis, cancer or adenoma.

 (2) Most of the carcinoma were found in the rightsided colon by follow-up examination.

 (3) False-negative rates of endoscopic examination are 27.4% for the lesions smaller than 5 mm in diameter and 12.5% for 5~10 mm lesions. False-negative rate is high, around 30%, and is decreasing in number in order of the ascending colon, rectum and sigmoid colon.

 (4) Demonstrability of routine x-ray examination for colo-rectal superficial neoplasms are 60% for Ⅱa and Ⅱa-like adenoma smaller than 5 mm, and 47% for Ⅱa+Ⅱc, Ⅱa+Ⅱc-like adenoma, Ⅱc and Ⅱc-like tumors including Ⅱc+Ⅱa early cancer and Ⅱc+Ⅱa-like adenoma. Nine lesions out of 21 lesions that were endoscopically overlooked were demonstrated by routine x-ray examlnahon.

 (5) In almost all cases with Ⅱa and/or Ⅱa-like adenoma, the other simultaneously co-existent elevated lesion or lesions such as elevated type of adenoma and/or Ⅱa type of early carcinoma were found. In the 112 cases, 17 superficial type of tumor were detected. Even 5 advanced cancer cases were newly found, also, in the 112 cases. In the 39 cases with Ⅱa+Ⅱc early carcinoma and/or Ⅱa+Ⅱc-like adenoma, co-existent 11 superficial type of tumor were detected. In the case with Ⅱc cancer and/or Ⅱc-like adenoma including Ⅱc+Ⅱa and Ⅱc+Ⅱa-like adenoma, however, the number of coexisting elevated type of adenoma is small in number and no superficial tumor was found.

 Based on the results mentioned above, the authors came to the conclusion as bellow: In almost all of the cases, colo-rectal superficial tumor may occur multiply, either simultaneously or metachronously. It is veryimportant to demonstrate and diagnose such a lesion or lesions as overlooked lesion or lesions, so to speak, with follow-up examination.

Copyright © 1993, Igaku-Shoin Ltd. All rights reserved.


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