INTESTINE Vol.12 No.3(2-3)

Theme Considering of the endoscopic classification in development of early colorectal cancer
Title Endoscopic macroscopic classification for colorectal cancer
Publish Date 2008/05
Author Takeshi Nakajima Division of Endoscopy, National Cancer Center Hospital
Author Takahisa Matsuda Division of Endoscopy, National Cancer Center Hospital
Author Yutaka Saito Division of Endoscopy, National Cancer Center Hospital
[ Summary ] Any endoscopic morphological classification for colorectal cancer needs to be practical and easy to understand. We basically classify colorectal cancer in accordance with the macroscopic classification outlines estabilished by the Japanese Society for Cancer of the Colon and Rectum. Also covered in the outlines are classifications of LST appearance and magnifying findings. In regard to LST appearance, LST-G type and LST-NG type, must be determined. The LST-NG type must be removed en bloc because of a higher potential for malignancy and greater difficulty in diagnosing submucosal depth and extent of invasion compared to the LST-G type. If a lesion has multiple components, careful examination and classification according to the original definition is necessary. In relation to magnifying colonoscopic findings, the clinical classification termed “Invasive pattern”, consisting of irregular, distorted colonic gland crypts in a demarcated area is used. This suggests the invasion of colorectal neoplasms into the deep submucosal layer. In addition, PG / NPG classification is useful in understanding the morphological growth paftern of colorectal cancer.
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