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Diagnosis and Prediction of Prognosis by Endoscopy in Superficial Type of Esophageal Cancer M. Endo 1 1Institute of Gastroenterology, Tokyo Women's Medical College pp.353-358
Published Date 1976/3/25
DOI https://doi.org/10.11477/mf.1403107124
  • Abstract
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 Superficial type of esophageal cancer confined at most to the submucosa has been quite few in number of reported cases. For the past 11 years only 27 cases, representing 4 per cent of all resected cancer of the esophagus, have been described. Prior to surgical intervention superficial type was endoscopically confirmed in 58 per cent. Tne reminders were mistaken for advanced cancer. Characteristic changes of this variety of cancer in its whole aspect are a very important clue to its endoscopic diagnosis, but its dynamic observation is also effective.

 In superficial type of cancer, neoplasms less than 3 cm in diameter accounted for 52 per cent, while in advanced cancer such small tumors were seen in only 10 per cent. Almost all of these small neoplasms belonged to early cancer with no lymph node metastasis. Turbidity, corseness and thickening of the mucosa accounted for m cancer, seen either as flatelevated type or erosive variety. Cancers elevated more than 3 mm above the mucosal surface in resected specimen or those with grossly ulcerated change belonged all to sm cancer.

 A definite difference in the prognosis of superficial type of cancer was seen between early cancer free of lymph node metastasis and superficial cancer involving lymph node. Study of the deceased either of early cancer or of superficial cancer shows that vascular invasion plays an important role in mortality. There is also a closs relationship between the histologic types of cancer, early or superficial, and vascular invasion. the latter was recognized in almost all cases of poorly differentiated carcinoma, while in cases of moderately differentiated carcinoma it was seen in 67 per cent and in well differentiated cancer in only 17 per cent. In this respect, preoperative determination of the histologic types by means of biopsy seems necessary in predicting prognosis.

 It has been suggested here that combination of elevated and erosive types confirmed by endoscopy is clinically more malignant than others not only from the histologic type and frequency of vascular invasion but from postoperative end-results as well.


Copyright © 1976, 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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