Stomach and Intestine(Tokyo) Volume 49, Issue 7 (June 2014)

Preoperative Diagnosis of Complete Resection Possible Colon Deep Invasive Cancer:nvasion Depth Diagnosis of Early Stage Colon Cancer by Normal Endoscopy Tetsuhiro Noda 1,2 , Osamu Tsuruta 1,2 , Shuichiro Nagata 1,2 , Yasuhiko Maeyama 1,2 , Shin Hasegawa 1,2 , Hikaru Yoshida 1,2 , Hiroaki Sumie 1,2 , Michita Mukasa 1,2 , Junya Masuda 1,2 , Kotaro Kuwaki 1,2 , Jun Akiba 3 , Hiroshi Kawano 4 , Keiichi Mitsuyama 1 , Michio Sata 1 , Takuji Torimura 1 1Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan 2Division of Endoscopy, Kurume University Hospital, Kurume, Japan 3Division of Pathology, Kurume University School of Medicine, Kurume, Japan 4Division of Gastroenterology, St Mary's Hospital, Kurume, Japan Keyword: 通常内視鏡観察 , 深達度診断 , SM浸潤度分類 , 内視鏡治療 , 適応拡大 pp.1003-1014
Published Date 2014/6/25
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 We assessed the diagnostic performance of normal endoscopy for advance pSM invasive cancer with invasion depths of 1,000μm, 1,500μm, or 2,000μm using sensitivity, specificity, positive predictive value, and negative predictive value. The lesions examined included 103 of pM cancer, 306 of pSM cancer, and 403 of early colon cancer. Endoscopic findings were used to indicate any significant relationships of the invasion depth of pSM cancer with disease characteristics including (1) the presence or absence of perilesional extension failure, (2) the presence or absence of recessed deep, and (3) the presence or absence of a tense feeling. As a result, the most important findings were a tense feeling in the diagnosis with a sensitivity and specificity and recessed deep in the diagnosis with a specificity and a positive predictive value. Further, by the addition of 2 other diagnostic findings, it was possible to slightly improve the diagnostic accuracy. Satisfactory diagnostic results were achieved when focusing on A)sensitivity and specificity and B)the positive predictive value and specificity. It is accompanied with a problem proportion of cases to turn to the next inspection that becomes high. Further study is required to efficiently make a decision regarding appropriate therapy.

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49巻7号 (2014年6月)
電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院