| 特集名 | 真の大腸IIcとは --形態の問題点 | |
|---|---|---|
| 題名 | 大腸IIcの形態学的特徴 --とくに陥凹形態から見て〈原著〉 | |
| 発刊年月 | 1998年 01月 | |
| 著者 | 為我井 芳郎 | 佼成病院外科 |
| 【 要旨 】 | 要旨はありません。 | |
| Theme | True type IIc colorectal lesion? -- An issue of its morphological diagnosis | |
|---|---|---|
| Title | Histomorphological features of IIc type colorectal cancers | |
| Author | Yoshiro Tamegai | Department of Surgery, Kosei General Hospital |
| [ Summary ] | In order to clarify the histomorphology of IIc (or IIc+IIa) type colorectal cancers, we examined the shape of the depressed area, histological features of the marginal areas of lesions, and distributions of Ki-67 positive cells. The objects were 124 depressed lesions of 99 patients (82 males and 17 females; average, 57.3 years old), which consisted of 80 adenomas, 16 mucosal cancers, and 28 submucosal invasive cancers. The shape of the depressed area was classified into: Type A, minute depression; Type B, holly-leaf shaped; Type C, star-shaped, Type D, wide and irregular; Type E, oval. Among the 96 lesions which were either adenoma or mucosal cancers, 21 (including8 mucosal cancers) were classified into Type D, the cancer frequency of which (38.1%) was the highest among the 5 types. Histological features of the marginal area of the depressed lesions were classified into: Type I, superficial spreading; Type II, intermediate; Type III, extensive proliferation. In regard to the shape of the depressed area and the growth pattern, the cancer frequency was high in cases with a combination of Type III and Type B, C or D. The distribution of Ki-67 positive cells was examined in 44 lesions of 37 patients (14 adenomas, 10 mucosal cancers, 20 submucosal invasive cancers). Cases showing a distribution mainly in the mucosal surface were classified as S, and those showing a transmural, distribution as T. Over all 12 (85.7%) of 14 adenomas were S, and 29 (96.7%) of 30 mucosal and submucosal invasive cancers were T. In regard to the shape of the depressed area and the distribution of Ki-67 positive cells (n=33), 11 of 15 Type C lesions were S, and all 14 Type D lesions were T. Because the proliferating pattern of a star-shaped lesion (Type C) is seen on the mucosal surface, the lesion undergoes morphological changes. Wide and irregular lesions (Type D) show extensive proliferation and Ki-67 positive cells are located transmurally. Therefore, biological features of IIc (or IIc+IIa) type colorectal cancers are most clearly shown in Type D lesions. |
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