予後不良な早期消化管癌の病理組織学的特徴—大腸癌

Pathological Characteristics of Early Colorectal Cancer with Poor Prognosis

要旨●大腸癌の予後不良である組織型および病理組織学的所見を示し，実際のT1癌症例での予後との関連性について検討した．予後不良な組織型は低分化腺癌，印環細胞癌，内分泌細胞癌，invasive micropapillary carcinoma，未分化癌が挙げられた．予後不良な病理組織学的所見は，リンパ管侵襲，静脈侵襲，神経侵襲，簇出，低分化胞巣，未熟間質，リンパ節構造のない壁外非連続性癌進展病巣が挙げられた．実際のT1大腸癌症例では，予後不良な組織型および病理組織学的所見を有する症例は非常に少数で予後に対する影響は軽微であり，病理組織学的所見による予後予測は難しいと考えられた．

　Histological types and findings are correlated with the poor prognosis of colorectal cancer. Herein, their relationship with prognosis in actual T1（submucosal invasion）cancer cases was examined. Histological types with poor prognosis included poorly differentiated adenocarcinoma, signet-ring cell carcinoma, endocrine cell carcinoma, invasive micropapillary carcinoma, and undifferentiated carcinoma. Histological findings with poor prognosis included lymphatic invasion, venous invasion, perineural invasion, tumor budding, poorly differentiated clusters, immature stroma, and extramural tumor deposits without lymph node structure. Among the actual cases of T1 colorectal cancer, only a few had records of histological type and findings with poor prognosis. Hence, the effect on prognosis was minimal. Therefore, prognosis is difficult to predict by only using pathological findings.