Saito Shoichi, Tajiri Hisao, Ohya Tomohiko, Nikami Toshiki, Aihara Hiroyuki, Ikegami Masahiro
Department of Endoscopy, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-Ward, Tokyo 105-8461, Japan.
Int J Surg Oncol. 2011;2011:242608. doi: 10.1155/2011/242608. Epub 2011 Feb 10.
Introduction. This study examined whether magnifying endoscopy with NBI observation (ME-NBI) could be useful selecting the appropriate treatment for submucosal invasive cancer (SM cancer). Patients and Methods. We analyzed 515 cases of colon tumors excised endoscopically or surgically. We classified capillary network pattern into four types according to the degree of dilatation, irregularity, and distribution of microcapillary features. Results. The comparison of capillary pattern and histological features revealed microcapillary networks by using confocal laser-scanning microscopy and ME-NBI in intramucosal lesion or SM cancer with remnant neoplastic glands at the superficial layer. In contrast, the network was absent in SM cancer with desmoplastic reactions, which invaded deeper into the submucosal layer. Conclusions. The remaining microcapillary network is designed to maintain the architecture of neoplastic glands. Consequently, loss of this network could correlate with depth of tumor invasion and desmoplastic reaction. Therefore, we can decide the appropriate treatment by using ME-NBI method.
引言。本研究探讨了窄带成像放大内镜检查（ME-NBI）在选择合适的黏膜下浸润癌（SM癌）治疗方法方面是否有用。患者与方法。我们分析了515例经内镜或手术切除的结肠肿瘤病例。我们根据微毛细血管特征的扩张程度、不规则性和分布将毛细血管网络模式分为四种类型。结果。毛细血管模式与组织学特征的比较显示，在黏膜内病变或表层有残留肿瘤腺体的SM癌中，通过共聚焦激光扫描显微镜和ME-NBI观察到了微毛细血管网络。相比之下，在伴有促纤维组织增生反应且浸润至黏膜下层更深部位的SM癌中未观察到该网络。结论。剩余的微毛细血管网络旨在维持肿瘤腺体的结构。因此，该网络的缺失可能与肿瘤浸润深度和促纤维组织增生反应相关。所以，我们可以通过ME-NBI方法来决定合适的治疗方案。
