| Theme |
Small invasive cancer of colon and rectum less than 10 mm |
| Title |
Clinicopathologic characteristics of colorectal cancer less than 10 mm in size invading submucosa and below |
| Author |
Kazuko Beppu |
Department of Gastroenterology, Juntendo University, School of Medicine |
| Author |
Takeshi Terai |
Terai Clinic |
| Author |
Naoto Sakamoto |
Department of Gastroenterology, Juntendo University, School of Medicine |
| Author |
Kenshi Matsumoto |
Department of Gastroenterology, Juntendo University, School of Medicine |
| Author |
Tomoyoshi Shibuya |
Department of Gastroenterology, Juntendo University, School of Medicine |
| Author |
Hiroki Mori |
Department of Gastroenterology, Juntendo University, School of Medicine |
| Author |
Taro Osada |
Department of Gastroenterology, Juntendo University, School of Medicine |
| Author |
Masato Kawabe |
Department of Gastroenterology, Juntendo University, School of Medicine |
| Author |
Akihito Nagahara |
Department of Gastroenterology, Juntendo University, School of Medicine |
| Author |
Michiro Otaka |
Department of Gastroenterology, Juntendo University, School of Medicine |
| Author |
Tatsuo Ogihara |
Department of Gastroenterology, Juntendo University, School of Medicine |
| Author |
Sumio Watanabe |
Department of Gastroenterology, Juntendo University, School of Medicine |
| [ Summary ] |
Recent advances in technologies and methodologies for endoscopic diagnosis have provided detection of small colorectal cancer. However, it remains difficult to detect the invasive depth of colorectal cancer when it is less than 10 mm in size. Since endoscopic treatment is appropriate only for cancer exceeding SM2, that is those which extend below the SM3 level and require surgery. This study evaluated the clinicopathologic characteristics of cancer less than 10 mm in size, which has invaded the submucosa and below by dividing it into two groups : SM 1 to 2 and SM 3 and below.
54 cases of colorectal cancer less than 10mm in size invading the submucosa and deeper tissues, were examined (39 cases of SM 1 and 2 ; 15 cases of SM3 and below). Endoscopic appearance indicated that rates of depressed type occurrence were higher than those for the protruded type in SM3 cases and those which were more invasive. For a more detailed analysis, endoscopic findings such as leukoderma in the protruded type, and fullness, leukoderma, hardness and protruded lesions of the depressed area in the depressed type are useful for evaluating cancer invading SM3 and below. Positive rates of lymphatic and venous permeation and rates of moderately differentiated adenocarcinoma in cases invading SM3 and below were signiflcantiy higher than those with SM1-2 invasion. The rate of lymph node metastasis in cancer which had invaded the submucosa and below was 9.3 % . In this study, colorectal cancer less than 10 mm in size which had invaded the submucosa and below showed molecular, biological characteristics similar to submucosal cancer. |