Endoscopic Characterization for Differentiation of Mucosal and Submucosal Carcinomas in the Esophagus Hiroyasu Makuuchi 1,2 , Toshio Mitomi 1 , Tomoo Tajima 1 1Department of Surgery, Tokai University School of Medicine Keyword: 早期食道癌 , 食道表在癌内視鏡診断 , 食道色素内視鏡 , ヨード(ルゴール)染色 pp.1051-1058
Published Date 1990/9/25
DOI https://doi.org/10.11477/mf.1403111404
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 In Japan, detection of patients with early and superficial carcinoma in the esophagus has inproved because of developments of a slender fiberscope, and techniques of chromo-endoscopy such as iodine staining. So far, we have encountered 95 cases with superficial esophageal carcinoma with invasion limited to the submucosal layer. They represent 19.4% of 409 cases with carcinomas in the thoracic esophagus treated in our hospital. Detected analyses of these cases revealed that mucosal carcinomas rarely invade the vessels and metastasize to the lymph nodes. Thus, a 5-year survival rate was 100%. On the other hand,33% of cases with submucosal carcinoma had lymph node metastasis and their 5-year survival rate was 52.4%. In this paper, we described endoscopic characteristics for their differentiation of mucosal and submucosal carcinoma.

 Briefly, mucosal carcinomas are flat (0-Ⅱb),2 mm or smaller elevated lesions (0-Ⅱa). They often look white, and have shallow erosion (0-Ⅱc) with regular granular bases. On the contrary, submucosal carcinomas are usually elevated lesions larger than 2 mm or deep irregular ulcers covered with white debris. Using these criteria, accuracy in diagnosis was approximately 82%. Some of the mucosal carcinomas invading nearly as far as the mucosal muscle layer and submucosal carcinomas with microscopic invasion of the submucosal layer were misdiagnosed.

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