| Theme | Pathological evalution of submucosal invasive colorectal cancer | |
|---|---|---|
| Title | The significance of desmoplastic reaction in the diagnosis of submucosal invasive carcinoma of the colon and rectum | |
| Publish Date | 2000/03 | |
| Author | Takashi Nishigami | Second Department of Pathology, Hyogo College of Medicine |
| [ Summary ] | The relationship between the depth of submucosal invasion by colorectal carcinoma and desmoplastic reactions was studied in cases which were 72 sm2 (up to 500μm from the muscularis mucosa) tumors (33.0%), 70 sm2 tomors (32.1%) and 76 sm3 (34.9 %). Desmoplastic reaction was not observed at the surface of sm1 tumors, but was seen in 68 out of 70 sm2 tumors and 74 out of 75 sm3 tumors. Investigation of the relationship between the degree of submucosal invasion and lymph node metastasis in 155 patients operated on showed that four of 50 sm2 patients (8 %) and eight of 66 sm3 patients (12.1%) had lymph node metastasis, whereas one metastasis (2.6 %, histological carcinosarcoma) was found in 39 sm1 cases. These results indicate that surgical excision should be made when desmoplastic reaction is detected through biopsy ; endoscopic mucosal excision is recommended when there is no reaction. If the cancer is sm2 or more highly invasive, additional excision is required. |
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