Takemasa I, Nishisho I, Fujitani K, Shin E, Mishima H, Hasuike Y, Kobayashi K, Kobayashi T, Kikkawa N, Takeda M
Dept. of Surgery, Osaka National Hospital.
Gan To Kagaku Ryoho. 1998 Jul;25(9):1297-300.
Colorectal cancer (CRC) infiltrating the submucosa (sm cancer) and the proper muscle (mp cancer) represent an early and an intermediate stage in the development of CRC, and sm and mp cancer are therefore appropriate to discuss the natural history of CRC. A total of 337 sm cancers and 291 mp cancers resected in our series were evaluated. We divided sm and mp cancers into three categories, respectively, sm 1, sm 2, sm 3, mp 1, mp 2, and mp 3, according to the depth of infiltration of the submucosa or the proper muscle. The deeper the invasion, the larger of the tumor size, and the proportion of depressed type in their configuration increases. On the contrary, the proportion of tumors with adenomatous component decreases. A larger proportion of tumors in all categories of infiltration showed PG more of ten than that of NPG in their marginal structure. In this study, 17% of sm cancer and 23% of mp cancer might develop not via the adenoma-carcinoma sequence.
浸润至黏膜下层的结直肠癌(CRC,黏膜下层癌)和固有肌层的结直肠癌(肌层癌)分别代表CRC发展的早期和中期阶段,因此黏膜下层癌和肌层癌适合用于探讨CRC的自然病史。我们对本系列中切除的337例黏膜下层癌和291例肌层癌进行了评估。根据黏膜下层或固有肌层的浸润深度,我们将黏膜下层癌和肌层癌分别分为三类,即sm1、sm2、sm3、mp1、mp2和mp3。浸润越深,肿瘤大小越大,其形态中凹陷型的比例增加。相反,具有腺瘤成分的肿瘤比例降低。在所有浸润类别中,较大比例的肿瘤在其边缘结构中显示PG的频率高于NPG。在本研究中,17%的黏膜下层癌和23%的肌层癌可能并非通过腺瘤-癌序列发展而来。