医学
粘膜下层
粘膜肌层
淋巴血管侵犯
结直肠癌
息肉切除术
浆膜
癌症
腺癌
淋巴结
癌
淋巴结转移
转移
病理
胃肠病学
内科学
结肠镜检查
作者
Ryuichi Kikuchi,Masahiro Takano,Koichi Takagi,N. Fujimoto,Ryoichi Nozaki,T. Fujiyoshi,Yuzo Uchida
出处
期刊:Diseases of The Colon & Rectum
[Ovid Technologies (Wolters Kluwer)]
日期:1995-12-01
卷期号:38 (12): 1286-1295
被引量:610
摘要
The purpose of this study was the evaluation of various factors in the formulation of guidelines for treatment of early invasive colorectal cancer, in which malignant cells extend through the muscularis mucosa into the submucosa but do not deeply invade the muscularis propria.A total of 182 patients were followed for at least five years or until death, with early invasive cancer diagnosed between 1982 and 1989. Patients were grouped according to the level of invasion, as follows: 64 patients with slight carcinoma invasion of the muscularis mucosa (200-300 microns; sm1), 82 with intermediate invasion (sm2), and 36 with carcinoma invasion extending to the inner surface of the muscularis propria (sm3).The configuration, diameter, and histologic grade of adenocarcinoma and lymphovascular invasion were correlated with level of invasion. After endoscopic polypectomy or local resection, 4 patients showed local recurrence and 13 patients showed lymph node metastasis. None of these 17 patients had sm1 disease. The level of invasion, configuration, and location were significant risk factors for development of lymph node metastasis or local recurrence (P < 0.05), but lymphovascular invasion, histologic grade, and diameter were not risk factors.Preoperative assessment of the level of invasion using this classification, in which the submucosa is divided into three depths, may decrease the incidence of unnecessary surgery for sessile polyps. Assessment according to the level of invasion is useful in the formulation of appropriate guidelines for the treatment of early invasive cancer.
科研通智能强力驱动
Strongly Powered by AbleSci AI