Differences in Biological Grade between Polypoid Growth and Non-polypoid Growth Types in Protruded Early Colon Cancer Akihiro Ouchi 1,2 , Osamu Tsuruta 1,2 , Tosihiro Araki 1,2 , Tomonori Cho 1,2 , Yosio Kusaba 1,2 , Tomoyuki Nakane 1,2 , Hidenori Tokuyasu 1,2 , Tsutomu Nagata 1,2 , Shuhei Fukunaga 1,2 , Atsushi Hinosaka 1,2 , Michita Mukasa 1,2 , Keigo Emori 1,2 , Erina Ueno 3 , Hiroshi Kawano 3 , Keiichi Mitsuyama 1 , Takuji Torimura 1 1Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan 2Division of Endoscopy, Kurume University School of Medicine, Kurume, Japan 3Division of Gastroenterology, St Mary's Hospital, Kurume, Japan Keyword: 隆起型早期大腸癌 , 大腸SM癌 , PG type , NPG type , 生物学的悪性度 pp.889-896
Published Date 2019/5/25
DOI https://doi.org/10.11477/mf.1403201764
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 On the basis of the cleft morphology of the lesion in protruded submucosal invasive(SM)colon cancer, the lesions in this study was divided into PG(polypoid growth)and NPG(non-polypoid growth)types. For this study, 113 SM colon cancer lesions of either PG or NPG types were compared to determine differences in their biological grade by evaluating histological type, the presence or absence of adenoma component, size, submucosal infiltration, vascular invasion, and budding. Histologically, the lesions of both PG and NPG types are differentiated cancers. However, compared with that in the lesions of PG type, the presence of adenoma component was significantly lower in the lesions of NPG type, which were smaller in size and showed deeper submucosal infiltration. No significant difference was observed in lymphatic and venous invasions for the two types. However, the frequency of budding was significantly higher in the lesions of NPG type, with evidence suggesting that these lesions are more aggressive in early colon cancer. These findings suggest a higher biological grade for the lesions of NPG type than those of PG type, indicating that the classification of protruded early colon cancer into PG and NPG types may help in differentiating the biological grade between the two.

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