| 特集名 | 直腸（Rb）癌の謎 | |
|---|---|---|
| 題名 | ［総論］(2) 部位別にみた肉眼型別（隆起型，表面型，陥凹型）の腺腫～早期癌病変 -- 直腸Rb，Raの情報を主体とした検討 | |
| 発刊年月 | 2010年 11月 | |
| 著者 | 池原 伸直 | 昭和大学横浜市北部病院消化器センター |
| 著者 | 工藤 進英 | 昭和大学横浜市北部病院消化器センター |
| 著者 | 前田 康晴 | 昭和大学横浜市北部病院消化器センター |
| 著者 | 宮地 英行 | 昭和大学横浜市北部病院消化器センター |
| 著者 | 若村 邦彦 | 昭和大学横浜市北部病院消化器センター |
| 著者 | 和田 祥城 | 昭和大学横浜市北部病院消化器センター |
| 著者 | 大塚 和朗 | 昭和大学横浜市北部病院消化器センター |
| 著者 | 濱谷 茂治 | 昭和大学横浜市北部病院病理科 |
| 【 要旨 】 | 直腸癌は生物学的悪性度が高い可能性があることは従来から述べられてきたことであるが，その発生や発育進展の違いは高いレベルの根拠をもって証明されていない．陥凹型腫瘍の発生さらには進展を考えるうえで，直腸癌とくに直腸Rb癌におけるそれは，初期病変はすべてpure IIc型の形態をとるのであろうか？ 突然de novoのごとくIIa＋IIc型の形態をとるのか？などといった疑問がつきない．直腸（Rb）癌の謎を少しでも解明できるように十分な症例を蓄積し，検討を行うことが必要である． | |
| Theme | Mystery concerning the lower rectum | |
|---|---|---|
| Title | Early colorectal cancer : comparison of clinical rectal cancer and colon cancer features | |
| Author | Nobunao Ikehara | Division Disease Center, Showa University Northern Yokohama Hospital |
| Author | Shin-ei Kudo | Division Disease Center, Showa University Northern Yokohama Hospital |
| Author | Yasuharu Maeda | Division Disease Center, Showa University Northern Yokohama Hospital |
| Author | Hideyuki Miyachi | Division Disease Center, Showa University Northern Yokohama Hospital |
| Author | Kunihiko Wakamura | Division Disease Center, Showa University Northern Yokohama Hospital |
| Author | Yoshiki Wada | Division Disease Center, Showa University Northern Yokohama Hospital |
| Author | Kazuo Otsuka | Division Disease Center, Showa University Northern Yokohama Hospital |
| Author | Shigeharu Hamatani | Department of Pathology, Showa University Northern Yokohama Hospital |
| [ Summary ] | The incidence of colorectal cancer is increasing in Japan. Clearly, preventing, detecting and treating colorectal cancer in the early stages is of utmost importance. However, few early colorectal cancer cases can be detected in spite of the high number of advanced colorectal cancers which are eventually detected. The aim of our study was to demonstrate the characteristics of early rectal cancer as compared to early colon cancer. A total of 2,205 early colorectal cancers, including 532 submucosal invasive cancers, were resected endoscopically or surgically from April 2001 to Deccember 2009 at our facility. We pathologically diagnosed massively invasive submucosal lesions, using Kudo's classification of the degree of submucosal invasion. Their gross appearance was devided into the following categories ; protruded, flat, and depressed type. IIc and IIc+IIa leasions had lower incidence rates in the rectum. LST lesions in the rectum, especially LST granular-nodular mixed type, exhibited a higher incidence than those types in the colon. Submucosal invasive cancers in the rectum exhibited significantly high incidences of vessel infiltration (p=0.00477) and submucosal massive invasion (p=0.00753). These results indicate that depressed type cancer in the rectum may not be visible in the early phases of carcinogenesis. |
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