| Theme |
Metastasis in colorectal submucosal cancer of IIc origin |
| Title |
Significance of histopathological findings on submucosal colorectal carcinoma in relation to regional lymph node metastasis |
| Author |
Yasutoshi Kobayashi |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Hiroshi Kashida |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Ryo Chinzei |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Keita Sasajima |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Syungo Endou |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Fumio Ishida |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Shigeji Hamatani |
Department of Pathology, Showa University Northern Yokohama Hospital |
| Author |
Shin-ei Kudo |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| [ Summary ] |
One hundred and four submucosal carcinomas were clinicopathologically examine to evaluate risk factors for lymph node metastasis. Twelve cases were accompanied by lymph node metastasis. In relation to lymph vessel permeation, 54 cases were determined to be ly1 and 17 cases were ly2. In cases involving venous permeation, 41 cases were considered to be v1 8 cases were v2. There were no liver metastasis cases. All cases having lymph node metastasis were of the invasive type (sm1c-3). All cases were classified into two groups ; those with or without lymphnodal metastasis. Six factors were compared in the two groups. (1) Classification of gross appearance (2) Degree of submucosal invasion (3) Histolocal type (4) The presense or absence of lymphatic permeations in the colorectal wall (5) the presence or absence of venous permeation in colorectal walls. (6) The presense or absence of budding. With these Six factors, lymphatic permeation, histological type and degree of submucosal invasion showed higher rates of lymphnode metastasis, compared to those without these findings. Chromoendoscopy and magnifying endoscopic images of colorectal lesions are useful for accurate diagnosis. These modalities may also be used to predict histology, and therefore are useful in determining treatment opinions ; whether endoscopic or surgical. We also explained strategies for colonrectal lesion treatment used in our institution. |