| Theme |
Pit pattern diagnosis of sm invasive colorectal carcinoma |
| Title |
Clinical significance of type V pit pattern classification in diagnosis of depth of invasion of early colorectal cancer |
| Author |
Yuichiro Tsuji |
The Second Department of Internal Medicine, Division of Gastroenterology and Endoscopy, Kurume University School of Medicine |
| Author |
Osamu Tsuruta |
The Second Department of Internal Medicine, Division of Gastroenterology and Endoscopy, Kurume University School of Medicine |
| Author |
Hiroshi Kawano |
The Second Department of Internal Medicine, Division of Gastroenterology and Endoscopy, Kurume University School of Medicine |
| Author |
Mitsutake Fujita |
The Second Department of Internal Medicine, Division of Gastroenterology and Endoscopy, Kurume University School of Medicine |
| Author |
Shiro Miyazaki |
The Second Department of Internal Medicine, Division of Gastroenterology and Endoscopy, Kurume University School of Medicine |
| Author |
Atsushi Toyonaga |
The Second Department of Internal Medicine, Division of Gastroenterology and Endoscopy, Kurume University School of Medicine |
| Author |
Michio Sata |
The Second Department of Internal Medicine, Division of Gastroenterology and Endoscopy, Kurume University School of Medicine |
| Author |
Nobuyuki Arima |
Department of Pathology, Kurume University School of Medicine |
| [ Summary ] |
We evaluated the usefulness of magnifying endoscopy in the diagnosis of the depth of invasion in 121 colorectal tumors (adenoma: 58 lesions, early cancer: 63 lesions).
The following results were obtained. Sensitivity and accuracy in the diagnosis of a deep invasion into the submucosa (sm2-3) was remarkably lower than specificity. In the relation between pit patterns and histological findings, sm2-3 cancer was never found with a pit pattern other than type V. 83.3% of the lesions with type VN pits invaded into Sm2-3. However, the lesions with type VI pits included two adenomas, fifteen intramucosal cancers, five slightly invasive cancers (sm1) and nineteen sm2-3 cancers. From the preceeding results, we were able to understand the reasons why diagnostic sensitivity by magnifying endoscopy was remarkably low. Therefore, to advance our ability to diagnose deep invasion into the submucosa by pit patterns, it was deemed necessary to create the subclassification of type VI pit patterns by recognizing small desmoplastic reactions, and the degeneration and disaprearance of crypts that appear on the invasive cancerous surface. |