Diagnosis of Invasion Depth for Early Carcinomas of Digestive Tract: Basis and Procedures Yusuke Saitoh 1 , Yuhei Inaba 1 , Motoya Tominaga 1 , Takahiro Sasaki 1 , Ryuji Sugiyama 1 , Ryuji Sukegawa 1 , Ken-ichiro Ozawa 1 , Masaki Taruishi 1 , Kin-ichi Yokota 2 , Mikihiro Fujiya 3 1Digestive Disease Center, Asahikawa City Hospital, Asahikawa, Japan 2Division of Gastroenterology Medical Corporation, Yoshida Hospital, Asahikawa, Japan 3Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Japan Keyword: 早期消化管癌 , 深達度診断 , リンパ節転移 , 内視鏡摘除 pp.485-497
Published Date 2015/5/24
DOI https://doi.org/10.11477/mf.1403200275
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 For diagnosing the invasion depth for early carcinomas of the digestive tract, it is necessary to review different findings associated with each carcinoma : esophageal, gastric, and colorectal. Lesion findings that require basic and essential examining and analyses are protrusion, erosion, ulcer, and mucosal color. Based on these four parameters, lesion size and macroscopic type can be accurately determined, and the invasion depth can be diagnosed. As a fundamental method of diagnosing the invasion depth, the abnormal findings should be interpreted from the outside region of the lesion, followed by the border of the lesion, and finally, the inside of the lesion. The interpretation of the abnormal findings started from the inside of the lesion may be one of the reasons leading to the misdiagnosis of the invasion depth. Further, for the detailed examination of suspected localized part of the lesion, it is better to proceed with magnifying endoscopy(with narrow band images)for the confirmed diagnosis of the depth than conventional endoscopy using dye-spraying method. Similarly, endoscopic ultrasonography may be conducted when the invasion depth is not accurately determined after conventional endoscopy and magnifying endoscopy.

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