| Theme |
New Development of Laterally Spreading Tumor |
| Title |
Prediction of Cancer Invasion in Colorectal LST -- Image‒Enhanced Endoscopy with Magnification Using Chromo or Narrow‒Band Imaging (NBI) |
| Author |
Hiroshi Kashida |
Department of Gastroenterology and Hepatology, Kinki University Faculty of Medicine |
| Author |
Yoriaki Komeda |
Department of Gastroenterology and Hepatology, Kinki University Faculty of Medicine |
| Author |
Toshiharu Sakurai |
Department of Gastroenterology and Hepatology, Kinki University Faculty of Medicine |
| Author |
Yutaka Asakuma |
Department of Gastroenterology and Hepatology, Kinki University Faculty of Medicine |
| Author |
Hiromasa Mine |
Department of Gastroenterology and Hepatology, Kinki University Faculty of Medicine |
| Author |
Teppei Adachi |
Department of Gastroenterology and Hepatology, Kinki University Faculty of Medicine |
| [ Summary ] |
Laterally spreading tumors (LSTs) are sub‒grouped as granular (LST‒G) and non‒granular (LST‒NG) types. The former is further sub‒classified into homogeneous [LST‒G（H)] and nodular mixed [LST‒G (M)] types, whereas the latter is divided into flat‒elevated [LST‒NG (F)] and pseudo‒depressed [LST‒NG (PD)] types. The sub‒classification is important as each subgroups is quite different from each other. Image‒enhanced endoscopy with magnification using chromo or Narrow‒Band Imaging (NBI) is useful for characterization of the tissue and prediction of cancer invasion.
Type LST‒G (H) and LST‒NG (F) can be intramucosal cancers when they present with irregular vascular or pit patterns, but they rarely invade the submucosal layer. Type LST‒G (M) is often invasive at the nodular part, but the depth of invasion is sometimes difficult to predict. Note that invasion can occasionally occur at the focus apart from the nodular part. Type LST‒NG (PD) is most often associated with slight submucosal invasion and fibrosis. It is sometimes difficult to predict the depth of invasion. Moreover, the invasion points can be multifocal. |