INTESTINE Vol.7 No.2(1-3)


特集名 LST由来の進行癌(sm深部浸潤癌も含む)-- LSTの自然史を巡って
題名 LST由来の進行癌の臨床病理学的特徴 (3) 表層拡大型腫瘍もしくは“30mm以上のLST”由来進行癌の病理学的特徴
発刊年月 2003年 03月
著者 味岡 洋一 新潟大学大学院医歯学総合研究科分子・病態病理学
著者 渡辺 英伸 新潟大学大学院医歯学総合研究科分子・診断病理学
著者 安田 一弘 大分医科大学第一外科
【 要旨 】 要旨はありません。
Theme Advanced colorectal cancer arisen from LST (laterally spreading tumor)
Title Pathological characteristics of advanced colorectal carcinoma originating in LST (laterally spreading tumors) over 30mm in size
Author Yoichi Ajioka Division of Molecular and Functional Pathology, Department of Molecular Genetics, Course for Molecular and Cellular Medicine, Graduate School of Medical and Dental Sciences, Niigata Uneversity
Author Hidenobu Watanabe Division of Molecular and Diagnostic Pathology, Department of Molecular Genetics, Course for Molecular and Cellular Medicine, Graduate School of Medical and Dental Sciences, Niigata Uneversity
Author Kazuhiro Yasuda Department of Surgery, Oita Medical University
[ Summary ] In 2,535 surgically resected advanced colorectal carcinomas, 33 tumors (1.3%) were thought to have originated from "LST over 30mm" (LST-advs.). LST-advs. were more frequently thought to be mp-cancer and were located less in the left-sided of the colon and more in the lower rectum, compared to non-LST-advs. The macroscopic appearance of remnant intramucosal neoplastic components in LST-advs. were "nodular-aggreaged" (21/33,64%), villous (8/33,24%), lobular (2/33,6%), and undermined (2/33,6%). Residual adenomatous components were seen in 27/33 (82%) tumors and 20/27 (74%) contained villous/tubulovillous histology. Compared with other advanced carcinomas, the incidence of tumors with carcinoma with low-grade atypia were predominant in the invasive area (8/33,24%), and tumors with mucinous component (7/33,21%) were significantly higher in LST-advs.. The invasive area within LST-advs. was located centrally in 23/33 (70%) and at the periphery in 10/33 (30%) In all tumors, accompanying adenomatous components, carcinoma was surrounded by adenomatous intramucosal histological component of adenoma, low-grade carcinoma, and high-grade carcinoma. Intramucosal components continuously adjacent to the invasive area were considered to be high-grade carcinoma in 25/33 (76%), These data indicate that 1.3% of advanced colorectal carcinoma could be considered to originate in LST over 30mm in size, especially from the LST-G subtype. However, tumors the would been originated from the LST-NG subtype may not be selected in this study and the incidence of 1.3% would be a minimal estimation for advanced carcinoma, originating from LST. LST-advs. was thought to develop through a sequential progression from adenoma to low-grade carcinoma, high-grade carcinoma, and invasive carcinoma, and it was thought to play an important role in the development of mucinous carcinoma.
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