実体顕微鏡および臨床からみた早期大腸癌の発生・発育・進展

Pertaining to Histopathogenesis, Growth and Progression of Early Cancer of the Colon and Rectum in Terms of Dissecting Microscopy and Clinical Aspects

要旨　大腸癌切除標本251例の主病変を除く大腸粘膜と，行政解剖149例の大腸粘膜を実体顕微鏡で観察し，早期大腸癌18病変，腺腫230病変を得たが，それらの病変と臨床で得られた早期大腸癌117病変より次のような結果を得た．（1）大腸癌は，腺腫の癌化より，de novo carcinomaのほうが多い．（2）早期大腸癌の発育形式は，de novo carcinomaから発育し微小のⅡbまたはⅡaから急速に深部に発育・進展するものと，腺腫が癌化し，carcinoma in adenomaの形から比較的ゆっくり進展するものとがある．

　Seemingly healthy parts of resected colorectal cancer (251 samples), suffering from colorectal cancer (but not including target cancers), were contrasted with colons not normally considered to be associated with cancer (149 samples obtained after coroner's inquests).

　This was carried out by dissecting microscopy and 18 lesions of early colorectal cancer and 230 lesions of adenoma were detected.

　We have come to the following conclusions, based on the lesions mentioned above and 117 clinically detected early colorectal cancers:

　1. De novo cancers of the colon and rectum are more frequent than cancers originating as adenomas.

　2. Early cancer of the colon and rectum can be broken down into two patterns of progression: (a) rapid‐cancerous depth invasion shown by minute Type-Ⅱb or Type-Ⅱa, arising from de novo. (b) relatively slow‐cancer in adenoma shown by an adenoma eventually becoming cancerous.