Stomach and Intestine(Tokyo) Volume 54, Issue 6 (May 2019)

Colorectal Submucosal Cancer of Protruded and Polypoid Growth Type from the Viewpoint of Infiltration Type(on the Features of 0-Is, Isp Lesions) Eiji Harada 1 , Hiro-o Matsushita 1 , Kenjiro Yoshikawa 1 , Ryo Takagi 1 , Yoshihito Tanaka 1 , Bunichiro Kato 1 , Yuko Yoshida 1 , Shin Sasaki 1 , Hiroshi Hashimoto 1 , Takuo Tokairin 2 , Katsuhiko Enomoto 2 , Hironori Aoki 3,4 , Kazunori Tsuda 5 , Hiro-o Yamano 6 1Department of Digestive disease center, Akita Red Cross Hospital, Akita, Japan 2Department of Diagnostic Pathology, Akita Red Cross Hospital, Akita, Japan 3Department of Gastroenterology, Teine-Keijinkai Hospital, Sapporo, Japan 4Department of Molecular Biology, Sapporo Medical University Sapporo, Japan 5Department of Gastroenterology, Kobe Red Cross Hospital, Kobe, Japan 6Department of Gastroenterology and Hepatology, Sapporo Medical University School of Medicine, Sapporo, Japan Keyword: 大腸T1癌 , 大腸SM癌 , 隆起型早期大腸癌 , PG type , 浸潤形式 , 通常内視鏡 , 拡大内視鏡 pp.898-912
Published Date 2019/5/25
  • Abstract
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 We investigated the clinical, endoscopic, and pathological features of submucosal colorectal cancer classified into four groups based on the degree of remaining of mucosal muscle plate and the intramucosal or estimated intramucosal carcinoma portion.

 The rate of diagnostic accuracy based on the degree of the depth in the protruded type is low compared to the surface type. In this study, we also confirmed that the diagnostic accuracy rate was lower than that of the surface type, in particular, the lesions remaining in the intramucosal or estimated intramucosal carcinoma portion and the lesions not accompanied by desmoplastic reaction.

 Both pit pattern observations using a magnifying endoscope and ordinary endoscopic observations, such as assessing fullness, are important for improving the diagnostic accuracy rate of protruded-type early colorectal cancer, which determines the diagnosis based on depth. In difficult cases, actively searching for other diagnostic modalities such as ultrasound endoscopy and lower intestinal GU series was necessary.

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54巻6号 (2019年5月)
電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院