| Theme |
Frontier of image diagnosis for colorectal carcinoma |
| Title |
Endoscopic diagnosis for early colorectal carcinoma using conventional colonoscopy |
| Author |
Yuji Inoue |
Institute of Gastroenterology, Tokyo Women's Medical University |
| Author |
Toyohiko Karibe |
Institute of Gastroenterology, Tokyo Women's Medical University |
| Author |
Shiho Yamamoto |
Institute of Gastroenterology, Tokyo Women's Medical University |
| Author |
Yuka Kaneko |
Institute of Gastroenterology, Tokyo Women's Medical University |
| Author |
Yoshihisa Saijo |
Institute of Gastroenterology, Tokyo Women's Medical University |
| Author |
Masakazu Yamamoto |
Institute of Gastroenterology, Tokyo Women's Medical University |
| [ Summary ] |
We assessed the efficacy of endoscopic diagnosis of early colorectal cancer using conventional colonoscopy. Currently the indications for curative endoscopic resection are intramucosal carcinomas and submucosal carcinomas with less than 1,000μm SM invasion without any risk factors for lymph node metastasis. Therefore, it is considered important to diagnose submucosal carcinomas with greater than 1,000μm SM invasion ("SM massive" carcinomas). Endoscopic findings of "SM massive" carcinomas are the following ; apparent expansion, endoscopically observed stiffness, uneven surfaces and depressed surfaces. We also diagnosed "SM massive" carcinomas using these colonoscopic findings. If conventional colonoscopy reveals linearization on the tumor surface, the degree of submucosal invasion is almost (85%) certain to be 1,500μm or higher. It was difficult to diagnose submucosal carcinomas under 1,000μm. Submucosal carcinomas were also difficult to diagnose using non-lifting signs. However, it has become possible to diagnose carcinomas with a higher degree of certainly, including intramucosal carcinomas. We can consider the diagnosis of early colorectal carcinoma, to have reached acceptable levels. However, further improvements in colonoscopy and progress in diagnostic studies will improve diagnostic accuracy. |