Abstract
We evaluated the possibility of an extended application of endoscopic treatment for submucosal invading colorectal cancers. Patients and Methods: 232 submucosal invading cancers were examined from 1985 to November 1999. We classified the submucosal extension according to the vertical level of invasion as sm1, sm2 or sm3. The depth of vertical invasion in the submucosal layer was measured in micrometer. The patterns of infiltrating growth into the submucosal layer were further divided into two groups: expanding growth with a distinct border, and infiltrating growth with an indistinct border. Result: On comparison of measurement of submucosal invasion with relative classification, the mean depths in the sm1a group, sm1b group, sm1c group, sm2 group, and sm3 group were 302±179(SD)μm, 403±86(SD)μm, 596±452(SD)μm, 2559±157(SD)μm, 3205±1599(SD)μm respectively. Statistical significances were recognized in these groups (Ftest, t-test). Lymph node metastasis occurred in sm2 and extension cancer in more advanced stages. As for patterns of invasion, the frequencies of lymph node metastasis in the groups of expanding growth and infiltrating growth were 0%(0/54) and 9%(6/67), respectively (p=0.03,χ2-test). The frequencies of infiltrating growth in the protruded type and depressed type were 39% and 71%, respectively (p
Published Version
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