| 特集名 | IIc由来のsm癌を考える | |
|---|---|---|
| 題名 | 臨床の立場から --私はこう考える (3) 大腸IIcの発育進展 --臨床病理学的見地から | |
| 発刊年月 | 1999年 07月 | |
| 著者 | 為我井 芳郎 | 前 佼成病院臨床検査科 / 秋田赤十字病院胃腸センター |
| 【 要旨 】 | 要旨はありません。 | |
| Theme | Submucosal invated cancer derived from the IIc region | |
|---|---|---|
| Title | Development and progression of type IIc colorectal cancers | |
| Author | Yoshiro Tamegai | Department of Clinical Laboratory, Kosei General Hospital / Division of Gastroenterology, Akita Red Cross Hospital |
| [ Summary ] | We have studied the depressed-type colorectal tumors in order to clarify questions about their development and progression from morphological and biological viewpoints. The subjects were 140 depressed-type early colorectal tumors of ll3 patients (93 males and 20 females ; average, 58.3 years old), this included 88 with adenomas, 17 with mucosal cancers, and 35 with submucosal invaded cancers. In regard to the above-mentioned lesions we examined the shape of the depressed area, the marginal pit pattern of the depressed portion, histopathological features and distributions of Ki-67 positive cells so as to clarify characteristic and developmental process of depressed-type early colorectal cancers. Besides this, we also examined the developmental process of cancers from a viewpoint of the histological analysis (especially existence of ulceration and so on) of depressed-type submucosal cancers. As a result it was considered that the shape of the depressed area, the marginal pit pattern of the depressed area ("Niveau Difference"), histopathology and distribution of Ki-67 positive cells were associated with one another and also all of these factors might regulate the developmental process. In addition depressed-type tumors those shape of depressed area was found to have round-irregular shape with "Niveau Difference(+)" [ND(+)] showing extensive proliferation and that Ki-67 positive cells are located transmurally. These lesions indicate higher rate of incidence of cancer and have the characteristic of depressed-type colorectal cancers. On the other hand, depressed-type neoplasms had a thorny appearance with "Niveau Difference(-)" [ND(-)], Many of those lesions have distributions of Ki-67 positive cells on the mucosal surface and morphological changes are noted. In conclusion it is suggested that most IIc or IIc+IIa type cancers are mucosal or slightly submucosal invading cancers without accompanying ulceration. However as they invade deeply, they are thought to develop into IIa+IIc, or Is+IIc type submucosal cancers. |
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