| [ Summary ] |
Methods were summarized for estimating type of macroscopic precursor (intramucosal) lesions associated with submucosal colorectal carcinoma. Using histopathology, precursor lesions are estimated by investigating the height or width of remnant intramucosal neoplastic submucosal carcinomial components. PG / NPG classification is based on the height of intramucosal neoplasia at the tumor margin. Using endoscopy, the presence or absence of depressions with type IIIs pit patterns plays an important role in the estimation of submucosal carcinoma, which may originate in type IIc lesions. Using X-ray retrospective examination, precursor lesions are estimated by using a combination of macroscopic findings (height of lesion and presence of depression) related to the initial lesion and pathological findings of the resected tumor, as to whether they are PG or NPG. Histological risk factors for lymph node metastasis of colorectal submucosal carcinoma were of histological grade, cytologically atypical, and displayed high levels of submucosal invasion, vascular invasion, and budding. Histological diagnosis and pitfalls of evaluation were summarized. |