Clinical Gastroenterology Vol.18 No.3(5)

Theme Early Colorectal Cancer -- Recent Topics
Title Conventional Colonoscopic Findings Useful for the Invasion Depth Diagnosis in Early Colorectal Carcinomas
Publish Date 2003/03
Author Yusuke Saitoh Third Department of Internal Medicine, Asahikawa Medical College
Author Mikihiro Fujiya Third Department of Internal Medicine, Asahikawa Medical College
Author Yuhei Inaba Third Department of Internal Medicine, Asahikawa Medical College
Author Jiro Watari Third Department of Internal Medicine, Asahikawa Medical College
Author Yutaka Kohgo Third Department of Internal Medicine, Asahikawa Medical College
Author Tomoyuki Ohta Department of Gastroenterology, Asahikawa Kosei General Hospital
[ Summary ] We reported on objective colonoscopic findings concerning sm2-3 cancers for each macroscopic type, which contribute to therapeutic strategies. Between Jan.1990 and Dec.2000, a total of 678 early colorectal cancers were detected and treated in our hospital. The macroscopic type was divided into the following categories 408 of the polypoid type (pedunculated and sessile), 270 of the flat, depressed type (F&D) type (172 of the flat elevated and 98 of the slightly depressed type). In relation to invasion depth, 503 were m to sm1 and 175 were sm2-3 cancers. We retrospectively reviewed chromoendoscopic findings of sm2-3 cancers and compared them with those of the m to sm1 type as suggested by procedure records. The results were as follows: 1. Objective colonoscopic findings for sm2-3 cancers suggest the following; the presence of a "depressed surface" or an "expanded appearance" in 408 of the polypoid type; "normal mucosa on the tumor border", the presence of an "expanded appearance" or of "folds converging toward the tumor" in 172 case of the flat elevated (IIa and Nodule aggregating) type; and the presence of "deep or irregular depressed surfaces", an "expanded appearance" or "folds converging toward the tumor" in 98 of the slightly depressed type (IIc and IIa+IIc) (all p values<0.01). 2. With combinated use of these colonoscopic findings, 600 lesions out of 678 (88.5%) were precisely determined in relation to therapeutic strategy.
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