| [ Summary ] |
This study conducted to determine endoscopic findings of the degree of submucosal invasion with Ila+1lc type submucosal invasive cancers of the colon. Studies were carried out on 32 cases of IIa+IIc type sm colonic cancer (21 males and 11 females with a mean age of 63.4 years) with 33 lesions. Morphological examinations according to sano's classification of IIa+IIc type early gastric cancer, morphological measurements, endoscopic findings, and pit patterns of 28 superficial type sm cancer lesions were statistically compared between sm1 and sm2 or sm3 cancers. We classified IIa+IIc type sm colonic cancers into three types according to sano's classification. The rates of sm3 cancers were 100% in deep invasive type, 54.5% in erosive type, and 15.8% in polypoid type. Morphological measurements revealed a significant size increase in the polypoid type lesions, compared with other types with all degrees of submucosal cancer invasion. Therefore, biological behavior is considered to be very different in these three types. Endoscopic findings were assessed by Student's t-test. There were significant differences in fold conversion, lesion height, expansiveness, erosive surface, depth and uneveness of the depressed area, and marginal undulation of the depressed area between sm1 and sm2 or sm3 cancers. Multivariate analysis (Logistic regression) revealed a significant difference in marginal undulation of the depressed area. The comparison of pit patterns showed that a significant proportion of sm2 and sm3 cancers did not have a non-structured type V pit pattern (according to Kudo's classification). Finally, when we make an endoscopic differential diagnosis of the degree of submucosal invasion, it is very important to recognize the morphological features of IIa+IIc type sm cancers. We must also carefully observe the morphological findings and pit patterns using magnifying endoscopy. |