| Theme |
Early Colorectal Cancer -- Recent Topics |
| Title |
Problems on the Pathological Diagnosis of Early Colorectal Carcinoma |
| Author |
Yoichi Ajioka |
Division of Molecular and Functional Pathology, Department of Molecular Genetics, Course for Molecular and Cellular Medicine, Graduate School of Medical and Dental Sciences, Niigata University |
| Author |
Hidenobu Watanabe |
Division of Molecular and Diagnostic Pathology, Department of Molecular Genetics, Course for Molecular and Cellular Medicine, Graduate School of Medical and Dental Sciences, Niigata University |
| Author |
Ken Nishikura |
Division of Molecular and Functional Pathology, Department of Molecular Genetics, Course for Molecular and Cellular Medicine, Graduate School of Medical and Dental Sciences, Niigata University |
| Author |
Gen Mukai |
Division of Molecular and Diagnostic Pathology, Department of Molecular Genetics, Course for Molecular and Cellular Medicine, Graduate School of Medical and Dental Sciences, Niigata University |
| Author |
Yoichiro Baba |
Division of Molecular and Diagnostic Pathology, Department of Molecular Genetics, Course for Molecular and Cellular Medicine, Graduate School of Medical and Dental Sciences, Niigata University |
| [ Summary ] |
There has been a reduction in the discrepancies in histological diagnoses for colorectal carcinoma between Japan and the West, and among Japanese pathologists. The former was caused by differences in definitions and in the use of terminology concerning carcinoma, and the latter were by differences in their histological criteria. Pathological diagnosis of vascular invasion, which is the most important risk factor for cancer lymph node metastasis, varies with different pathologists. To achieve reproducible diagnoses, the use of special staining, as well as H&E staining, is necessary. Sprouting and the degree of submucosal invasion are useful predicting factors for lymph node metastasis when endoscopically resected submucosal colorectal carcinoma showed no vascular invasion. The presence or absence of sprouting has recently been thought to correlate with APC mutation and MSI-H status. In general, the degree of submucosal cancer invasion has been assessed by absolute classification, and related guide lines have now been formulated by the Japanese Society for Cancer of the Colon and Rectum, Submucosal Cancer Project Group. Lymph node micrometastasis was detected in nearly 20% of submucosal colorectal carcinoma cases. Although its clinical significance is still unclear, we believe that there is a curative potential for endoscopic treatment of submucosal colorectal carcinoma without micrometastasis. |