| 特集名 | 大腸IIcの病理組織診断 --組織診断の違いはどこにあるのか? | |
|---|---|---|
| 題名 | 補助的検討による大腸IIcの組織診断 (3) 表面型癌の組織診断とPG,NPG分類 | |
| 発刊年月 | 1998年 03月 | |
| 著者 | 池上 雅博 | 東京慈恵会医科大学病理学講座第1 |
| 【 要旨 】 | 要旨はありません。 | |
| Theme | Histopathological Diagnosis IIc Type of Colorectal Cancer | |
|---|---|---|
| Title | Pathological granding of colorectal intramucosal superficial type cancers with special reference to development and intramucosal growth mode (PG and NPG) | |
| Author | Masahiro Ikegami | 1st Department of Pathology, Jikei University School of Medicine |
| [ Summary ] | We studied the histological grading of colorectal cancer by morphometrically analyzing the cellular atypism of adenomas and carcinomas. One-hundred sixty resected lesions of submucosal invasive cancer and 98 of intramucosal cancer, resected endoscopically during the past 10 years, were studied. The following indices were compared in this study : ratio of gland to stroma per unit area, nuclear cytoplasmic ratio, ratio of cells haning more than two nuclear to total nuclei in glands, nuclear size (horizontal and vertical), ratio of lengthwise to crosswise dimensions of nuclei and numbers of nucleoli per gland. There were significant differences between adenomas with low grade atypia and those with high grade atypia in all categores. In contrast, nuclear size (horizontal and vertical) and the ratio of lengthwise to crosswise nuclear dimensions were shown to be important diagnostic criteria for differentiating adenoma with severe atypia from carcinoma with low grade atypia. In other words, it was concluded that the characteristic microscopical features of carcinomas inciuded enlarged nuclei, particularly those exceeding 5 micrometers. We also studied enlarged nuclei, more than 5 micrometers, in regards to the size of neoplastic glands. We compared adenocarcinomas with high grade atypia to those with low grade atypia within the intramucosal area in sm invasive cancers with NPG type structures. The results suggest that colorectal carcinomas showing more than 40 to 50% nuclear enlargement should be diagnosed based intramucosal superficial type tumors could be classified into carcinomas and adenomas using our histological criteria. We also studied the pathological grading of intramucosal superiicial cancers and the intramucosal area of submucosal invasi cancers with NPG type structures. In intramucos superiicial cancer, low grade atypia was seen in :70%, in contrast to submucosal invasive cance showing a decrease in this ratio (17.3% in the intramucosal and 2.9% in the submucos partion). Thus, we concluded that there is a histolbgical grading change from low grade (atypism to high grade atypism with the growth: and development of colorectal cancers. |
|