Department of Surgery, Ohta Nishinouchi Hospital, Fukushima, Japan.
Dig Endosc. 2010 Oct;22(4):259-67. doi: 10.1111/j.1443-1661.2010.01010.x. Epub 2010 Aug 12.
Observations of esophageal squamous cell carcinoma using magnifying endoscopy have now been carried out extensively and, as a result, it has become clear that the morphology of the microvessels evident at the tumor surface reflects the depth of tumor invasion. In M1 and M2 cancer, the surface microvasculature reveals dilation and elongation of the intrapapillary capillary loops (IPCL). However, at this stage, some immature capillaries resembling IPCL also arise inside the tumor and, therefore, the view of the microvasculature should be described as one showing 'intermixing of modified IPCL and IPCL-like immature capillaries (IPCL-like abnormal capillary)'. As cancer invades into the muscularis mucosa (M3 or deeper), an obviously dilated and irregularly branched tumor-specific vasculature, more accurately described as 'neovasculature', can be observed. From our magnifying endoscopy observations and studies of the molecular profile of early esophageal cancer, we conclude that two major angiogenic steps exist in precancerous and M3 lesions in the early phase of cancer progression. In addition, it is now possible to study cell morphology using an endocytoscope with a much higher magnification (×400-×1000) than magnifying endoscopes currently on the market. The histology revealed in this way may reduce the need for conventional biopsy histology in the future.
目前已经广泛开展了使用放大内镜观察食管鳞状细胞癌的研究，结果表明，肿瘤表面可见微血管的形态反映了肿瘤浸润的深度。在 M1 和 M2 期癌症中，表面微血管显示出绒毛内毛细血管环（IPCL）的扩张和伸长。然而，在这个阶段，一些类似于 IPCL 的不成熟毛细血管也在肿瘤内部出现，因此，微血管的观察结果应该被描述为“改良的 IPCL 和 IPCL 样不成熟毛细血管（IPCL 样异常毛细血管）混合”。当癌症侵犯黏膜肌层（M3 期或更深）时，可以观察到明显扩张和不规则分支的肿瘤特异性脉管系统，更准确地描述为“新生血管”。从我们的放大内镜观察和早期食管癌的分子谱研究中，我们得出结论，在癌症进展的早期阶段，癌前病变和 M3 病变中存在两个主要的血管生成步骤。此外，现在可以使用放大内镜市场上的高倍放大倍数（×400-×1000）的内镜内细胞仪研究细胞形态。这种方式揭示的组织学可能会减少未来对常规活检组织学的需求。
