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Clinicopathological Characteristic of the Superficial Spreading Esophageal Squamous Cell Carcinoma Shin-ichiro Horiguchi 1 , Kumiko Momma 2 , Masae Takahashi 1 , Rin Yamada 1 , Naoki Sano 1 , Junko Fujiwara 2 , Tsuyoshi Kato 3 , Akinori Miura 3 , Yosuke Izumi 3 , Tsunekazu Hishima 1 1Department of Pathology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo 2Department of Endoscopy, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo 3Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo Keyword: 表面型表層拡大型 , 食道表在癌 , 網目状形態(腫瘍内ヨード染色域) pp.1131-1140
Published Date 2014/7/25
DOI https://doi.org/10.11477/mf.1403114222
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 Superficial spreading-type esophageal carcinoma is defined as“0-II type superficial carcinomas that spread ≧5cm in the long axis of the esophagus without any prominent elevations or depressions.”On the basis of this definition, 21 patients with simple superficial-type spreading carcinoma of the esophagus were divided according to the depth of invasion into two groups : group A comprising 8 patients with pT1a-EP/LPM invasion and group B comprising 13 patients with pT1a-MM/pT1b-SM invasion. These 2 groups were clinicopathologically compared with a control group, group C, comprising 5 patients with combined type, including some patients with 0-III type and some others with 0-I type carcinomas. All group C patients had a high rate of lymph node metastasis and vascular invasion associated with MM/SM invasion at the 0-I and 0-III-type sites, which clearly distinguished them from the group A and B patients. A key point in distinguishing group A with EP/LPM invasion and group B with MM/SM invasion was that there was a strong homology in the pathological characteristics of both groups in terms of 0-II type aspects which were difficult to differentiate. Although there were variations within the groups, mesh-like forms(iodine-stained areas in the tumor)were prominent in 4 group A patients(50%)and 3 group B patients(100%)(p=0.0011). The esophagus was speckled in appearance in 5 group A patients(75.0%)and 6 group B patients(46.2%), and there was a high ratio in group A. Invasion in group B was characteristically multicentric, occurring at a mean of 2.6 sites, and the dissemination from the centers of lesions was relatively narrow with a maximum invasion diameter of 0.2~11mm, which was suggestive of a multifocal origin. Moreover, submucosal invasion was observed while differentiation remained superficial with some advanced mixed intraductal components. Our results suggest that the pathological characteristics of Group B type lesions should be carefully analyzed because of the possible factors complicating the endoscopic diagnosis of invasion depth according the surface appearance.


Copyright © 2014, 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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