Trecca A, Fujii T, Kato S, Hasebe T, Tajiri H, Yoshida S
Dept. of Endoscopy, National Cancer Center Hospital East, Chiba, Japan.
Endoscopy. 1998 Jun;30(5):493-5. doi: 10.1055/s-2007-1001316.
Small advanced cancers (less than 10 mm in size) have rarely been described in the literature, mainly due to their difficult endoscopic diagnosis. A total of 5120 colonoscopic examinations were performed at the National Cancer Center Hospital East; three cases (0.05%) of small advanced cancer were found. The indigo carmine dye spraying technique with magnifying endoscopy was used for diagnosis. All cases were flat and depressed lesions (8, 9 and 9 mm in size respectively) with V type pit pattern at the magnifying observation. Histology showed three cancers with invasion to the proper muscle layer and two cases of lymph node metastasis. K-ras point mutation was negative in all cases, while p53 stained in two out of the three cases (one diffuse and one focal). It is concluded that small advanced colorectal adenocarcinomas are a reality. Our data on their macroscopic appearance and histology confirm their high malignant potential.
小的进展期癌症（大小小于10毫米）在文献中鲜有描述，主要是因为其内镜诊断困难。国立癌症中心东医院共进行了5120例结肠镜检查；发现了3例（0.05%）小的进展期癌症。采用靛胭脂染色技术结合放大内镜进行诊断。所有病例均为平坦凹陷性病变（大小分别为8、9和9毫米），放大观察时呈V型凹坑模式。组织学显示3例癌症侵犯固有肌层，2例有淋巴结转移。所有病例的K-ras点突变均为阴性，而3例中有2例p53染色阳性（1例弥漫性、1例局灶性）。结论是小的进展期结直肠癌是真实存在的。我们关于其宏观外观和组织学的数据证实了它们具有很高的恶性潜能。
