INTESTINE Vol.14 No.2(6)


特集名 大腸ESDとEMRのすみ分け
題名 切除標本の取り扱いと根治度判定のポイント
発刊年月 2010年 03月
著者 大倉 康男 杏林大学医学部病理学
【 要旨 】 EMR/ESD標本の根治度は病理組織学的に判定され,その結果をふまえて追加治療の検討が行われる.病理診断を正確に行うためには内視鏡切除標本の取り扱いが適切なことが前提である.本稿では標本の取り扱い方について概説した.切除標本の根治性は,病変が完全に切除されていること,さらにはリンパ節などの転移の可能性がないことが必要条件である.根治度判定のための組織所見である,切除断端,組織型,浸潤度,脈管侵襲,簇出について解説した.
Theme Selection of the therapeutic methods (EMR or ESD) for colorectal tumor
Title Handling and histological examination of endoscopically resected specimens of early colorectal cancer
Author Yasuo Ohkura Department of Pathology, Kyorin University School of Medicine
[ Summary ] The curability of EMR and ESD specimens is judged by histopathological examination, and additional treatment is decided on the basis of the results obtained. For the purpose of precise diagnosis, appropriate handling of endoscopically resected material is necessary. An outline illustrating methods to properly handle specimens is exhibited in this paper. Points related to histopathological examination of endoscopically resected material, such as cancer involvement at resected margins, histological type, depth of submucosal invasion, vessel invasion and tumor budding are explained according to the general rules for clinical and pathological studies of colonic, rectal and anal cancer. Guidelines for treatment of colorectal cancer published by the Japanese Society for Cancer of the Colon and Rectum are also presented.
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