| Theme |
Precancerous Conditions and Cancer High-risk Lesions in the Colorectum |
| Title |
Adenoma-carcinoma Sequence |
| Author |
Masahiro Igarashi |
Endoscopy Division, Cancer Institute Ariake Hospital |
| Author |
Akiko Chino |
Endoscopy Division, Cancer Institute Ariake Hospital |
| Author |
Teruhito Kishihara |
Endoscopy Division, Cancer Institute Ariake Hospital |
| Author |
Tadanori Kishi |
Endoscopy Division, Cancer Institute Ariake Hospital |
| Author |
Naoyuki Uragami |
Endoscopy Division, Cancer Institute Ariake Hospital |
| [ Summary ] |
There are two theories concerning colorectal cancer development, one in regard to the adenoma-carcinoma sequence the other in regard to de novo pathways. However, a primary cause has not been established. We primarily discuss means to diagnoses and treat colorectal cancer in relation to the adenoma-carcinoma sequence. Carcinoma may be diagnosed in association with adenoma. The most common colorectal carcinomas include the protruded type, i. e. Ⅰp, Ⅰsp, Ⅰs and LST-G lesions. Diagnosis was made possible by using the dye spraying method and NBI with magnifying observation. On the other hand, de novo cancers may be grouped with types IIc, IIc+IIa, Is+IIc and LST-NG, which were not associated with adenoma. The treatment of cancers related to the adenoma-carcinoma sequence was carried out using the guidelines of the Japanese Society for Cancer of the Colon and Rectum. Endoscopic resection was indicated for head invasion of I p type SM cancer. Surgical treatment was selected for stalk invasion of I p type SM cancers. |