Clinicopathologic Analysis of Nine Cases with Small Advanced Colorectal Carcinomas Less Than 10 mm in Maximum Diameter.

DOI 1 Citations 56 References
  • NAGATA Shinji
    Deipartmen t of En doscopt, Hiroshima Memona l HosPital
  • TANAKA Shinji
    First DePaitmen t of ln ternal Medicin e, Hiroshima Memorea l HosPital.
  • HARUMA Ken
    First DePaitmen t of ln ternal Medicin e, Hiroshima Memorea l HosPital.
  • HIYAMA Toru
    Deipartmen t of En doscopt, Hiroshima Memona l HosPital
  • KITADAI Yasuhiko
    Deipartmen t of En doscopt, Hiroshima Memona l HosPital
  • YOSHIHARA Masaharu
    Deipartmen t of En doscopt, Hiroshima Memona l HosPital
  • SUMII Koji
    DePartment of Pathology, Hiroshim 2a University School of Medicine, Hiroshima Memorial Hos Pital
  • KAJIYAMA Goro
    DePartment of Pathology, Hiroshim 2a University School of Medicine, Hiroshima Memorial Hos Pital
  • SHIMAMOTO Fumio
    DePartment of Pathology, Hiroshim 2a University School of Medicine, Hiroshima Memorial Hos Pital
  • HIRAGA Yuko
    Department of lnternal Medicine, Hiroshima Memonial Hospital

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  • 最大径１０ｍｍ以下の小進行大腸癌の特徴に関する臨床病理学的検討

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Abstract

We examined nine cases with a small advanced colorectal cancer less than 10 mm in maximum diameter. Regarding the macroscopic type, four were like Ilc, two were like Ila, and three were like ls. As for the distribution in coloreetum of these lesions, four were in sigmoid colon, three were in transverse colon, one was in caecum, and one was in descend-ing colon. No lesions were detected in rectum. The growth pattern of tumor was 8 NPG (non-polypoid growth) and one PG (polypoid growth). No K-ras point mutation was detected by PCR method in both 7 NPG and 1 PG lesions. Histologic grade at the deepest invasive portion was 2 W (well-differentiated), 4 Mw (moderately-well differentiated), 2 Mp (moderately-poorly differentiated), 1 Por (poorly differentiated), and 1 Muc (mucinous) adenocarcinomas. Lymphnode metastasis was present in 2 of 4 Mw lesions and in 1 of 2 Mp lesions (total 33% ;3/9). This incidence is high, although the size of lesions were small. Endoscopically, all lesions accompanied with converging folds and 71esions examined by magnifying colonoscope showed VN pit pattern. From these findings, we could diagndse that the depth of invasion of these small lesions were more than submucosal invasion before surgical resection. These results indicated that the small advanced colorectal cancers less than 10 mm in maximum diameter was similar to the characteristics of superficial depressed type cancer, as reported previously, in morphologic features, its distribution and having a higher malignant potential. The findings of converging folds and pit pattern are considered to be useful indicators of the invasion depth diagnosis.

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