| Theme |
Update on laterally spreading tumor (LST) |
| Title |
Diagnosis and therapeutic tactics for laterally spreading tumor |
| Author |
Kohei Kuroda |
Division of Gastroenterology, Akita Red Cross Hospital |
| Author |
Hiro-o Yamano |
Division of Gastroenterology, Akita Red Cross Hospital |
| Author |
Kentaro Sato |
Division of Gastroenterology, Akita Red Cross Hospital |
| Author |
Kenjiro Yoshikawa |
Division of Gastroenterology, Akita Red Cross Hospital |
| Author |
Yoshifumi Higashidani |
Division of Gastroenterology, Akita Red Cross Hospital |
| [ Summary ] |
>From the viewpoint of therapeutic tactics, it is important to diagnose laterally spreading tumors (LST) based on their clinicopathological characteristics. We have proposed that LSTs are classified into two types according to their morphology, the “granular type (LST-G)” or “non-granular type (LST-NG)”. Each type has two sub-groups. The former has the “homogenous type (LST-G-H)” and the “nodular mixed type (LST-G-M)”. The latter has the “flat type (LST-NG-F)” and the “pseudo-depressed type (LST-NG-PD)”.
LST-G-M and NG-PD are higher than the other two types in rates of early carcinomas and submucosal invasive carcinomas. Therefore, it is important to classify LSTs according to morphological type. Also, LSTs which exhibit type IIIL and IV pit patterns should be treated endoscopically, because there is no submucosal invasive carcinoma in these cases. On the other hand, LSTs which display VN pit patterns should not be treated endoscopically, because they are often submucosal invasive. The problem is that LSTs, which have type V1 pit patterns, have wide variety of pathological features. Therefore, we must carefully choose therapeutic tactics for their treatment. |