側方発育型腫瘍の診断と治療

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  • DIAGNOSIS AND TREATMENT OF LATERALLY SPREADING TUMOR

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Some flat elevated neoplasms spread extensively and circumferentially along the colonic wall although they are very short in height. This type of neoplasms is called "laterally spreading tumor (LST)", and is defined as lesions larger than 10mm in diameter. Laterally spreading tumor is classified into two types ; granular type and non-granular type. Granular type is sub-classified into homogeneous type and nodular mixed type. Non-granular type is divided into flat elevated type and pseudo-depressed type. Though the rate of submucosal invasion is generally low in LST, pseudo-depressed type shows high invasive rate ; 22.0% as a whole, 83.3% in those over 30mm in diameter. In order to select appropriate therapy for an LST, it is important to recognize its subtype and to predict the depth of cancer. Pit pattern diagnosis with magnifying endoscope is extremely useful for this purpose.

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