Watari J, Orii Y, Saitoh Y, Murakami M, Mizukami Y, Muranaka S, Ohta T, Takahashi K, Ohta H, Yamano M
Department of Gastroenterology, Asahikawa Kosei General Hospital.
Nihon Shokakibyo Gakkai Zasshi. 1995 Sep;92(9):1250-7.
To clarify the clinicopathological features of tumors with submucosal invasion, especially superficial elevated and sessile ones, histological architectures of 32 cases of submucosal invasive cancers were analyzed. They were classified into 3 types based on cross-section view: PG and NPG of Shimoda's classification and PG'. Histological architectures were drawn in accordance with these findings. In 7 PG-Ca which consisted of PG only, no apparent correlation was found between the tumor sizes and invasion depth of submucosal layer. However, 12 NPG-Ca which consisted of NPG only and 12 Mixed-Ca which include various cross-section views both showed massive invasion into the submucosa with 1 cm or more in tumor size. Therefore these two types were similar in biological behavior in terms of invasion depth. And degree of submucosal invasion tended to increase in the order of PG-Ca, Mixed-Ca and NPG-Ca. Examinating histological architectures of the Mixed-Ca tumors in details, all of these cancers were consisted of both PG and PG'. Of the 12 Mixed-Ca, 91.7% were proved to be PG dominant type. Macroscopically, I s and II a contained 88.9% and 40.0% of Mixed-Ca, respectively. In conclusion, these results suggest that PG' is a subtype of PG, and PG-Ca have a correlation between tumor invasion and alteration from PG to PG' in histological architectures among submucosal cancers. It is important to clarify morphological features of PG' in margin of I s and II a tumors in diagnosing the depth of early colorectal cancers.
为阐明黏膜下浸润性肿瘤，尤其是浅表隆起型和广基型肿瘤的临床病理特征，对32例黏膜下浸润癌的组织学结构进行了分析。根据横断面观察将其分为3型：下田分类中的PG型和NPG型以及PG'型。根据这些结果绘制组织学结构。在仅由PG组成的7例PG型癌中，未发现肿瘤大小与黏膜下层浸润深度之间存在明显相关性。然而，仅由NPG组成的12例NPG型癌和包括各种横断面观察结果的12例混合型癌均显示向黏膜下层的广泛浸润，肿瘤大小在1 cm或以上。因此，这两种类型在浸润深度方面的生物学行为相似。黏膜下浸润程度倾向于按照PG型癌、混合型癌和NPG型癌的顺序增加。详细检查混合型癌肿瘤的组织学结构，所有这些癌症均由PG和PG'组成。在12例混合型癌中，91.7%被证明是PG优势型。宏观上，Is期和IIa期分别包含88.9%和40.0%的混合型癌。总之，这些结果表明PG'是PG的一个亚型，并且在黏膜下癌中，PG型癌的肿瘤浸润与组织学结构中从PG到PG'的改变之间存在相关性。在诊断早期结直肠癌的深度时，明确Is期和IIa期肿瘤边缘PG'的形态特征很重要。
