| Theme | Small invasive cancer of colon and rectum less than 10 mm | |
|---|---|---|
| Title | Endoscopic diagnosis of small early colorectal cancer invasion depth | |
| Publish Date | 2008/09 | |
| Author | Kenjiro Yoshikawa | Division of Gastroenterology, Akita Red Cross Hospital |
| Author | Hiro-o Yamano | Division of Gastroenterology, Akita Red Cross Hospital |
| Author | Tomoaki Kimura | Division of Gastroenterology, Akita Red Cross Hospital |
| Author | Kentaro Sato | Division of Gastroenterology, Akita Red Cross Hospital |
| Author | Toyoki Kudo | Division of Gastroenterology, Akita Red Cross Hospital |
| Author | Ei-ichiro Yamamoto | Division of Gastroenterology, Akita Red Cross Hospital |
| Author | Eiji Harada | Division of Gastroenterology, Akita Red Cross Hospital |
| Author | Orie Takemura | Division of Gastroenterology, Akita Red Cross Hospital |
| [ Summary ] | Recently, many small neoplastic colorectal lesions have been detected through use of colonoscopy, and treated. Although the majority of treatments for these lesions is achieved through endoscopic resection, there exist a small number of submucosal deep invasive cancers and advanced cancers, 10 mm or less in diameter. In order to decide on the most appropriate treatment, accurate diagnosis of the depth of invasion is necessary. Early colorectal cancers were classified into 3 types (protruded type, flat type, and depressed type). Then characteristic endoscopic findings for submucosal deep invasive cancer 10 mm or less in diameter were examined. In conventional endoscopy, fullness is useful characteristic for submucosal deep invasive cancer of the protruded type or the depressed type. The presence of elevations in the depressed area is indicative of submucosal deep invasion the depressed type. With magnifying endoscopy, highly irregular VI and VN pit patterns are to some degree useful to diagnose submucosal deep invasion in all types. However, there exist a small number of lesions, of which the depth of invasion is difficult to diagnose by conventional or magnifying endoscopy. For such lesions, endoscopic resection may be used for the purpose of the diagnosis and the treatment. | |