腺瘤在结直肠癌发生中的作用：低级别异型增生腺瘤、高级别异型增生腺瘤及侵犯黏膜下层癌的分布差异。

The role of adenoma for colorectal cancer development: differences in the distribution of adenoma with low-grade dysplasia, high-grade dysplasia, and cancer that invades the submucosa.

作者信息

Ikeda Yoichi, Mori Masaki, Shibahara Kotaro, Iwashita Akinori, Haraguchi Yukiaki, Saku Motonori

机构信息

Department of Surgery and Clinical Research Institute, National Kyushu Medical Center, Fukuoka, Japan.

出版信息

Surgery. 2002 Jan;131(1 Suppl):S105-8. doi: 10.1067/msy.2002.119360.

DOI:10.1067/msy.2002.119360

PMID:11821795

Abstract

BACKGROUND

The purpose of this study was to elucidate the role of adenoma in the early stage of colorectal cancer development, we focused on the clinicopathologic relationship between adenoma with low-grade dysplasia (ALGD), adenoma with high-grade dysplasia (AHGD), and cancer that invades the submucosa in the colorectum.

METHODS

We clinicopathologically examined a total of 553 adenomas and 58 cancers that invaded the submucosa. The tissues were excised from 479 patients who underwent total colonoscopy.

RESULTS

The percentage of ALGD was 79.9% in the proximal colon, 70.5% in the distal colon, and 48.3% in the rectum, respectively. The percentages of AHGD and cancer were 14.5% and 5.6% in the proximal colon, 21.3% and 8.2% in the distal colon, and 35.4% and 16.3% in the rectum, respectively. In contrast with the distribution of ALGD, the distribution of both AHGD and cancer shifted from the proximal to the distal site, with a statistical significance (P <.01). When the distribution of adenoma was compared according to tumor size, both large- and small-sized AHGD showed a similar cancer distribution, however, both large- and small-sized ALGD showed different distributions.

CONCLUSION

An important role of AHGD for cancer development in the colorectum may relate to the similar distribution between AHGD and cancer; however, the different distributions observed between ALGD, AHGD, and cancer suggested that ALGD has only a slight association with the development of cancer.

摘要

背景

本研究的目的是阐明腺瘤在结直肠癌发生早期的作用，我们重点关注了大肠中低级别异型增生腺瘤（ALGD）、高级别异型增生腺瘤（AHGD）与侵犯黏膜下层的癌之间的临床病理关系。

方法

我们对总共553例腺瘤和58例侵犯黏膜下层的癌进行了临床病理检查。这些组织取自479例行全结肠镜检查的患者。

结果

ALGD在近端结肠中的比例分别为79.9%，在远端结肠中为70.5%，在直肠中为48.3%。AHGD和癌在近端结肠中的比例分别为14.5%和5.6%，在远端结肠中为21.3%和8.2%，在直肠中为35.4%和16.3%。与ALGD的分布相反，AHGD和癌的分布均从近端向远端转移，具有统计学意义（P<.01）。当根据肿瘤大小比较腺瘤的分布时，大、小尺寸的AHGD显示出相似的癌分布，然而，大、小尺寸的ALGD显示出不同的分布。