大小并不能决定早期浸润性结直肠癌的恶性程度。
Size does not determine the grade of malignancy of early invasive colorectal cancer.
作者信息
Matsuda Takahisa, Saito Yutaka, Fujii Takahiro, Uraoka Toshio, Nakajima Takeshi, Kobayashi Nozomu, Emura Fabian, Ono Akiko, Shimoda Tadakazu, Ikematsu Hiroaki, Fu Kuang I, Sano Yasushi, Fujimori Takahiro
机构信息
Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan.
出版信息
World J Gastroenterol. 2009 Jun 14;15(22):2708-13. doi: 10.3748/wjg.15.2708.
AIM
To clarify the clinicopathological characteristics of small and large early invasive colorectal cancers (EI-CRCs), and to determine whether malignancy grade depends on size.
METHODS
A total of 583 consecutive EI-CRCs treated by endoscopic mucosal resection or surgery at the National Cancer Center Hospital between 1980 and 2004 were enrolled in this study. Lesions were classified into two groups based on size: small (<or= 10 mm) and large (> 10 mm). Clinicopathological features, incidence of lymph node metastasis (LNM) and risk factors for LNM, such as depth of invasion, lymphovascular invasion (LVI) and poorly differentiated adenocarcinoma (PDA) were analyzed in all resected specimens.
RESULTS
There were 120 (21%) small and 463 (79%) large lesions. Histopathological analysis of the small lesion group revealed submucosal deep cancer (sm: >or= 1000 microm) in 90 (75%) cases, LVI in 26 (22%) cases, and PDA in 12 (10%) cases. Similarly, the large lesion group exhibited submucosal deep cancer in 380 (82%) cases, LVI in 125 (27%) cases, and PDA in 79 (17%) cases. The rate of LNM was 11.2% and 12.1% in the small and large lesion groups, respectively.
CONCLUSION
Small EI-CRC demonstrated the same aggressiveness and malignant potential as large cancer.
目的
阐明早期小和大的浸润性结直肠癌（EI-CRC）的临床病理特征，并确定恶性程度是否取决于肿瘤大小。
方法
本研究纳入了1980年至2004年间在国立癌症中心医院接受内镜黏膜切除术或手术治疗的583例连续EI-CRC患者。根据肿瘤大小将病变分为两组：小（≤10mm）和大（>10mm）。对所有切除标本分析临床病理特征、淋巴结转移（LNM）发生率以及LNM的危险因素，如浸润深度、脉管浸润（LVI）和低分化腺癌（PDA）。
结果
小病变120例（21%），大病变463例（79%）。小病变组的组织病理学分析显示，90例（75%）为黏膜下深层癌（sm：≥1000μm），26例（22%）有LVI，12例（10%）为PDA。同样，大病变组中380例（82%）为黏膜下深层癌，125例（27%）有LVI，79例（17%）为PDA。小病变组和大病变组的LNM发生率分别为11.2%和12.1%。
结论
早期小浸润性结直肠癌与大癌具有相同的侵袭性和恶性潜能。
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