| 特集名 | 消化器臨床医のための病理学 -- 特殊染色を含めて | |
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| 題名 | 早期を中心とした大腸癌の病理診断 (2) 癌の異型度，粘液形質，発育様式と悪性度の関連および鋸歯状病変の意義について | |
| 発刊年月 | 2007年 09月 | |
| 著者 | 八尾 隆史 | 九州大学大学院医学研究院形態機能病理 |
| 著者 | 古賀 裕 | 九州大学大学院医学研究院形態機能病理 |
| 著者 | 具嶋 正樹 | 九州大学大学院医学研究院形態機能病理 |
| 著者 | 恒吉 正澄 | 九州大学大学院医学研究院形態機能病理 |
| 【 要旨 】 | 大腸癌の病理診断における悪性度評価に関する重要な因子 (細胞異型度，細胞分化，発育様式) と鋸歯状病変の意義について最新の知見を含め概説する． 細胞異型に関しては，高異型度であるものは低異型度のものより悪性度が高い．細胞分化 (形質発現) に関しては，CD 10 (小腸型のマーカー) 陽性のものは静脈浸潤・肝転移を高率にきたす高悪性度癌である．発育様式に関しては，非隆起性発育型 (NPG型) 癌は隆起性発育型 (PG型) より高悪性度である． 鋸歯状病変に関しては，sessile serrated polyp (SSP) という概念が提唱され新たな癌化経路の初期病変として注目されているが，その病変の意義は今後の検討課題である． |
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| Theme | Guidebook of Pathology for Gastroenterologists and Hepatologists ; Including Special Stains and Immunohistochemistry | |
|---|---|---|
| Title | Pathological Diagnosis of Early Colorectal Cancer ; Biological Behavior in Association with Grades of Atypia, Mucin Phenotypes and Growth Patterns, and Significance of Serrated Lesions | |
| Author | Takashi Yao | Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University |
| Author | Yutaka Koga | Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University |
| Author | Masaki Gushima | Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University |
| Author | Masazumi Tsuneyoshi | Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University |
| [ Summary ] | This is an outline concerning significant factors related to biological behavior such as cytologic atypia, phenotypic expression and colorectal carcinoma growth patterns as well as the significance of serrated lesions. In regard to cytologic atypia, adenocarcinoma with high grade atypia tends to be more aggressive than that with low grade atypia. In phenotypic expression, CD 10 positive adenocarcinoma tends to be more aggressive, with high incidences of venous invasion and liver metastasis than other types. Concerning growth patterns, non-polypoid growth tends to be more aggressive than that with polypoid growth. In relation to serrated lesions, the concept of sessile serrated polyps has recently been proposed. This has drawn attention to these early lesions as new carcinogenetic pathways. However, the significance of these lesions remains to be proven. |
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