| Theme |
Development of diagnosis of magnifying endoscopy |
| Title |
Role of SA pattern in detecting invasive colorectal cancer -- comparing pit patterns with chromocolonoscopy and crystal violet staining |
| Author |
Shun-ichi Hayashi |
Shun-ichi Hayashi Clinic |
| Author |
Yoichi Ajioka |
Division of Diagnostic Pathology, Graduate School of Medical and Dental Sciences, Niigata University |
| Author |
Hironobu Ota |
Division of Gastroenterology, Saiseikai Niigata Daini Hospital |
| Author |
Koji Watanabe |
Division of Gastroenterology, Saiseikai Niigata Daini Hospital |
| Author |
Toru Ishikawa |
Division of Gastroenterology, Saiseikai Niigata Daini Hospital |
| Author |
Toshiaki Yoshida |
Division of Gastroenterology, Saiseikai Niigata Daini Hospital |
| Author |
Nobuyuki Musha |
Division of Surgery, Saiseikai Niigata Daini Hospital |
| Author |
Toshihiro Tsubono |
Division of Surgery, Saiseikai Niigata Daini Hospital |
| Author |
Yasuo Sakai |
Division of Surgery, Saiseikai Niigata Daini Hospital |
| Author |
Noriko Ishihara |
Division of Pathology, Saiseikai Niigata Daini Hospital |
| Author |
Yasuyuki Baba |
Division of Internal Medicine, Nippon Dental University Hospital |
| Author |
Tomoteru Kamimura |
Division of Gastroenterology, Saiseikai Niigata Daini Hospital |
| [ Summary ] |
It is difficult to detect invasive colorectal cancers even with chromocolonoscopic examination in case where the lesions have a remainant mucosal layer. Because of the numerous pits seen on the surface, these lesions are apt to be diagnosed as mucosal cancers. However, if the deeper cancers invade down into the submucosal layer, there is a higher risk of lymph node metastasis. Therefore, the correlation between chromocolonoscopic findings and vertical depth of submucosal invation were investigated in order to clarify methods of identifying these invasive cancers correctly. In the present study, we employ and compare two chromocolonoscopic findings using crystal violet, pit patterns and SA patterns employing staining patterns in the area between pits. Pit patterns were evaluated by means of fractal dimensions from the view point of complexities of the shapes. SA patterns were classified into three types, according to the density in staining. Close correlation was found between SA patterns and invasion depth. Little correlation was found between pit patterns and invasion depth. However, a close correlation was found between pit patterns and histologic glandular formations and cellular atypia. It is important to have a knowledge of SA patterns when detecting cancers down to the submucosal layer, especially in cases involving cancers with a remainant mucosal layer. |