増殖形態と肉眼型からみた大腸mp癌の臨床病理学的特徴 Clinicopathological Features of Colorectal Cancer Invading the Muscularis Propria According to Growth Type and Macroscopic Type

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大腸mp癌54例を増殖形態と肉眼型から分類し,リンパ節転移頻度,治療成績との関連を検討した.増殖形態はnon polypoid growth type(NPG)とpolypoid growth type(PG)に2分類し,肉眼型は腫瘤型,中間型,潰瘍型に3分類した.増殖形態はNPG29例,PG25例に分類され,最大径に差はなかったが,深達度はNPG癌がPG癌に比して深かった.mp癌のリンパ節転移頻度は28%で,占居部位別には結腸で20%,直腸で38%であった.リンパ節転移頻度と増殖形態,肉眼型との明らかな関連性は認められなかったが,第2群リンパ節転移陽性の2症例はいずれもNPG癌であった.また,直腸では潰瘍型で,逆に結腸では腫瘤型でリンパ節転移頻度が高かった.治癒切除症例52例中の直腸癌4例に再発を認め,全例NPG癌であり,肝転移再発の1例が潰瘍型,局所再発の3例は潰瘍型が2例,中間型が1例であった.大腸mp癌においては,直腸NPG癌の生物学的悪性度の高いことが示唆された.

We reviewed 54 patients with colorectal cancer invading the muscularis propria, to clarify the relationship between growth type and macroscopic type, and chnicopathological features. These were subclassified into two groups, and three groups, based on cross-section views : polypoid (PG) and nonpolypoid growth types (NPG) as to growth pattern, and protruding, intermediate, and deep ulcerated types as to macroscopic pattern. Twenty-nine cases were NPG, and 25 cases were PG. The depth of invasion of NPG was deeper than that of PG, although the mean size did not differ in the growth type. Cancers containing adenoma were more frequently PG than NPG. Lymph node metastasis was found in 28% of all the cases, in 20% of the cases in the colon, and in 38% of the cases in the rectum. There was no significant difference between growth type and macroscopic type, and lymph node metastasis. But, two cases with N2 station lymph node metastasis showed NPG. Four patients died due to cancer relapse, and all of them were rectal cancer with NPG. NPG cancer in the rectum appeared to have a malignant potential in mp colorectal cancer.

収録刊行物

  • 日本大腸肛門病学会雑誌

    日本大腸肛門病学会雑誌 55(3), 158-163, 2002-03

    The Japan Society of Coloproctology

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各種コード

  • NII論文ID(NAID)
    10008386275
  • NII書誌ID(NCID)
    AN00195100
  • 本文言語コード
    JPN
  • 資料種別
    NOT
  • ISSN
    00471801
  • データ提供元
    CJP書誌  CJP引用  J-STAGE 
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