Developmental Process of Colorectal Adenoma and Early Carcinoma Shinei Kudo 1 , Terukazu Muto 1 , Satoshi Shimoda 1 , Takeyasu Suda 2 , Jun Soga 3 1The First Department of Surgery, Niigata University School of Medicine pp.903-910
Published Date 1985/8/25
DOI https://doi.org/10.11477/mf.1403109858
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 Four hundred and seventeen colorectal adenomas and 220 early colorectal carcinomas,107 intramucosal (m) and 113 submucosal (sm), were analyzed.

 On the basis of the result of our present analysis on changes of gross configuration of adenomas involved by malignant transformation, it is suggested that adenomas increase their size with changes of gross configuration from sessile type to subpedunculated and further to pedunculated type.

 It is also suggested that, depending on which stage of configuration the adenomas are involved by malignant transformation, the developing direction of gross configuration of these lesions is to be influenced. No significant influence to the gross configuration is considered when the lesion remains in the early stages of carcinoma with mucosal involvement down to sm1b carcinoma, while the lesion may result in apparent changes of gross configuration when its invasion develops down to sm1c or further beyond.

 It is proved that Ip (pedunculated) type of carcinoma with submucosal involvement transforms to Ips (subpedunculated) type until the stage of sm1c and Ips type to Is (sessile) type until the stage of sm2. Ⅱa+Ⅱc (flat-elevated with depression) type of invasive carcinoma may transform Ⅱa (flat-elevated) type at the stage of sm2~3. It is considered that the developing direction of gross configuration may be different when malignant transformation occurs in the form of Ips or Ip (mountain route) as compared with the form of Ⅱa or Is (direct route).

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