Stomach and Intestine(Tokyo) Volume 47, Issue 4 (April 2012)
Japanese

Invasion Depth Diagnosis with HFUP and Feasibility of Indication Extension of Endoscopic Resection for Colorectal Submucosal Carcinomas Yusuke Saitoh 1 , Mikihiro Fujiya 2 , Jiro Watari 3 , Motoya Tominaga 2 , Masaki Taruishi 1 , Kenichiro Ozawa 1 , Shunsuke Nakajima 1 , Ryuji Sugiyama 1 , Kazumasa Nakamura 1 , Satoshi Suzuki 1 , Ryuji Sukegawa 1 , Atsushi Chiba 1 , Akio Takada 4 1Digestive Disease Center, Asahikawa City Hospital, Asahikawa, Japan 2Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Japan 3Division of Upper Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan 4Division of Pathology, Asahikawa City Hospital, Asahikawa, Japan Keyword: 大腸SM癌 , 超音波内視鏡 , 内視鏡治療 , 深部断端陽性 , 完全摘除 pp.491-502
Published Date 2012/4/25
DOI https://doi.org/10.11477/mf.1403113152
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 Between 2004.10 to 2010.12, HFUP was performed for 274 lesions of early colorectal carcinomas. Overall accuracy of invasion depth diagnosis was 72.5%, for M-SMs carcinomas and 87.8% for SM-m ones. Accuracy rate was significantly higher in SM-m carcinomas than M-SM-s ones in both polypoid and, Flat and depressed type carcinomas. During the same period, 64 lesions SM carcinomas were endoscopically resected and SM invasion distance was able to be measured and the average resected SM layer distance was 3,900±2,200μm. Of those, pathological vertical cut end was positive in 11 lesions and the average resected SM distance was 4,200±2,100μm. It was strongly suggested that possible resectable SM distance by endoscopy with negative vertical cut end was about 4,000μm. Using HFUP, SM invasion distance was able to be preoperatively measured and SM invasion distance on HFUP image was favorably correlated with those on histological specimens(correlation coefficient R=0.889, p<0.0001). Diagnostic accuracy for SM invasion distance 1,000μm was 95%, 85% and 83% by HFUP, conventional colonoscopy and barium enema study, respectively and it was significantly higher in HFUP than other modalities(p<0.05). Moreover, diagnostic accuracy for SM invasion distance 4,000μm that was endoscopically resectable SM invasion distance with negative cut end was 85%, 45% and 48% by HFUP, conventional colonoscopy and barium enema study, respectively and it was significantly higher in HFUP than in other modalities(p<0.0001). It is strongly suggested that HFUP will be the essential modality for the indication extension of endoscopic resection for submucosal carcinomas.


Copyright © 2012, Igaku-Shoin Ltd. All rights reserved.

基本情報

05362180.47.4.jpg
胃と腸
47巻4号 (2012年4月)
電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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