INTESTINE Vol.14 No.6(1-3)


「個人年間予約購読者用全文閲覧サービス」でこの号を見る
特集名 直腸（Rb）癌の謎
題名 ［総論］(3) 部位別にみた進行癌：直腸癌と結腸癌の対比 -- 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 池松 弘朗 国立がん研究センター東病院消化管腫瘍科
著者 依田 雄介 国立がん研究センター東病院消化管腫瘍科
著者 大野 康寛 国立がん研究センター東病院消化管腫瘍科
著者 西澤 雄介 国立がん研究センター東病院消化管腫瘍科
著者 金子 和弘 国立がん研究センター東病院消化管腫瘍科
著者 斎藤 典夫 国立がん研究センター東病院消化管腫瘍科
【 要旨 】 当院における大腸癌外科手術症例（1,843病変）を進行直腸癌（Ra, b）683病変と進行結腸癌（RS，S/C，D/C，T/C，A/C，Cecum）1,160例に分けて患者背景，臨床病理学的特性，再発・転移率について比較検討した．今回の解析から，(1) 進行直腸癌は男性に多く，有症状者に多く認めた．(2) 進行直腸癌は，有意差をもって大きさが大きく，pMP癌が多く，静脈侵襲を多く認めた．(3) 再発・転移率はリンパ節転移，肝転移は差がなかったが，局所再発，肺転移は有意差をもって進行直腸癌に多く認めた．以上より進行直腸癌と進行結腸癌は性質の違う癌である可能性が考えられた．
Theme Mystery concerning the lower rectum
Title Clinicopathological characteristics of advanced rectal cancer and colon cancer
Author Hiroaki Ikematsu Department of Gastroenterology & Gastrointestinal Oncology, National Cancer Center Hospital East
Author Yusuke Yoda Department of Gastroenterology & Gastrointestinal Oncology, National Cancer Center Hospital East
Author Yasuhiro Oono Department of Gastroenterology & Gastrointestinal Oncology, National Cancer Center Hospital East
Author Yusuke Nishizawa Department of Gastroenterology & Gastrointestinal Oncology, National Cancer Center Hospital East
Author Kazuhiro Kaneko Department of Gastroenterology & Gastrointestinal Oncology, National Cancer Center Hospital East
Author Norio Saito Department of Gastroenterology & Gastrointestinal Oncology, National Cancer Center Hospital East
[ Summary ] The number of colorectal cancer cases is increasing yearly. The incidence of lesions detected early on in the right side of the colon is higher than the number of advanced cancers. However, advanced cancer of the rectum is frequently detected. As a result, we compared the clinicopathologcal characteristics of advanced rectal cancer lesions with those of advanced colon cancer lesions. From January, 2000 to November, 2009 at the National Cancer Center Hospital East, 1,843 lesions received surgical treatment for advanced colorectal cancer was enrolled in this study. There were 683 lesions with rectal cancer, and 1,160 with colon cancer. There were many men with advanced rectal cancer, and a number of symptomatic patients. The mean size of advanced rectal cancer lesions was significantly larger than those lesions in the colon (p=0.009). Advanced rectal cancer lesions often involved muscle layer invasion. There was significantly more venous invasion in advanced rectal cancer lesions than in advanced colon cancer lesions (p<0.001). Major recurrent sites for advanced rectal cancer involved local recurrence in 3.7 % of patients, livers 10.2 %, and lungs 6.0%. Rates for advanced colon cancer were 1.2 %, 13.2 % and 2.5 % for the above mentioned.
In conclusion, we hypothesize that advanced rectal and colonic cancer may be of different natures.
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