| [ Summary ] |
Histological factors (the state of remnant mucosal components and the muscularis mucosae; m/mm, desmoplastic reactions on the surface of the tumor; DR, and depth of submucosal invasion; Vsm) and their corresponding pit patterns (PP) were analysed and the possibility of PP diagnosis of the depth of submucosal cancer invasion were studied in fifty nine colorectal submucosal carcinomas. Carcinomas were classified as those with submucosal shallow invasion (sm-s) (Vsm<1,000 micro m or deep invasion (sm-d) (Vsm>=1,000 micro m). PP correlated primarily with the state of m/mm and did not correlate directly with DR or Vsm. However, since the state of m/mm correlated with Vsm, indirect PP diagnosis of the Vsm is possible through the evaluation of the state of m/mm through PP analysis. The correlation between m/mm, pit patterns and the rate of sm-d were as follows; 1) m+/mm+: regular PP (88.9%), sm-d (44.4%), 2) m+/mm+-: regular (23.5%) or web/irregular PP (76.5%), sm-d (70.6%), 3) m+/mm-: web/irregular PP (93.7%), sm-d (93%), 4) in-/mm- irregular PP (53%) or low pit population (47%), sm-d (100%). From this data, it was considered that; 1) half of m-/mm- cancers can be diagnosed through PP by detecting their characteristic low pit population and these tumors can be regarded as sm-d, 2) PP diagnosis of sm-d in m+/mm+ and m+/mm+- groups seemed to be almost impossible. For these tumors, even PP diagnoses of submucosal cancer seemed to be difficult because of their regular PP, which is similar to that seen in intramucosal tumors, 3) PP diagnosis of m+/mm- cancer is the key to extending the efficacy of PP dignosis of sm-d. For this purpose, the differential diagnosis of web/irregular PP in m+/mm+- and m+/mm- should be established. |