Type Early Cancer Research Articles

Effectiveness of early cancer detection method: magnetic resonance imaging and X-ray technique

Cancer is a major problem plaguing human society today. With the research and development of nano-drug delivery technology and new non-surgical treatment methods, many types of early cancers can be cured or effectively controlled. However, the current treatment methods for advanced cancer are still limited, and efficient early cancer identification is crucial for enhancing patients prognosis and survival rates. Magnetic resonance imaging (MRI) and X-ray technologies are currently the mainstream and generally applicable means of early cancer detection. However, there is a lack of unified comparison and interpretation for their respective applicable cancer detection types. Herein, the paper first provides a comprehensive comparison and explanation of the working principles of the two technologies, as well as their advantages and disadvantages. Further, this article introduces the application of MRI and X-ray technology in the early detection of different common cancer types, including lung, breast, and brain cancers. The paper found that MRI is crucial in the early detection of brain cancer, and X-ray is a common method for lung cancer screening. With further advances in technology, cancer-related deaths can be further curbed.

Review: endoscopic submucosal dissection (ESD) and endoscopic mucosal resection (EMR)

Endoscopic resection within the gastrointestinal tract has changed the disease management paradigm for multiple premalignant conditions. Recently indications have expanded to include several types of early cancers as well. Unified by submucosal injections and a submucosal dissection plane, endoscopic resection techniques are generally divided into endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD). EMR is a natural extension of polypectomy, applied to a flat lesion after a submucosal injection. ESD is a technically more difficult technique that involves tunneling the endoscope into the submucosal plane, but may allow curative, en bloc , resections of early stage malignancies. This review evaluates an array of current evidence for pathologies within the gastrointestinal tract, appropriate preoperative evaluation, preparation and procedural techniques.

Characeristics of lymph node metastasis in early gastric cancer and feasibility of endoscopic resection

Objective To compare the clinicopathologic features of different types of early gastric cancer （ EGC）, and to investigate the risk factors of lymph node metastasis （LNM） and to explore the possi- bility of endospic resection（ER）. Methods The clinical data of the 524 EGC patients who underwent a curative gastrostomy between January 2000 and May 2011 in the hospital were analyzed, retrospectively. Clinieopathologic features were compared between different histological types and investigated by univariate and multivariate analysis for their possible relationship with LNM. Results Tumor size and depth of tumor invasion for signet ring cell cancers were significantly different from differentiated cancers and poorly differen- tiated cancers. The incidence of LNM for signet ring cell carcinoma was lower than poorly differentiated car- cinoma （9. 7% vs. 22. 2% ,P 〈 0. 05）, but not significantly different compared to differentiated cancers （ 13.1% ,42/321, P =0. 406）. Tumor size （P =0. 007）, depth of tumor invasion （P =0. 000）, histologi- cal ~ type （ P = 0. 030 ） , lymphatic involvement （ P = 0. 000 ） and ulceration （ P = 0. 002 ） showed positive correlations with LNM by univariate analysis. Multivariate analysis revealed that depth of tumor invasion （ P = 0. 007 ）, tumor size （ P = 0. 010 ）, histological type （ P = 0. 000 ）, and lymphatic involvement （ P = 0. 000） were independent risk factors of LNM. In signet ring cell carcinoma with mucosal invasion andwithout lympatic involvement, which were less than 2 cm in tumor diameter, no LNM was detected. Conclusion Early signet ring cell cacinoma has different clinicopathologic features from differentiated carci- noma and poorly differentiated carcinoma. We propose early signet ring intramucosal EGC 2 cm or less in size without lymphatic involvement can be performed by ER. Key words: Early gastric cancer; Lymph node metastasis ; Risk factors; Endoscopic resection

Evaluation of the cardiovascular health study (CHS) instrument and the Vulnerable Elders Survey-13 (VES-13) in elderly cancer patients. Are we still missing the right screening tool?

A geriatric screening tool would be valuable to identify elderly cancer patients who might benefit from a comprehensive geriatric assessment (CGA). This study evaluated the accuracy of the cardiovascular health study (CHS) instrument in predicting abnormality in CGA. The vulnerable elders' survey-13 (VES-13) was also evaluated. Patients aged ≥ 70 years with solid tumors underwent a CGA after being screened with the CHS and VES-13. Analyses were conducted for the overall population and according to the disease status (early or advanced) and type of early cancer (breast or gastrointestinal, GI). Of 259 patients, 75% were impaired according to the CHS and 47% according to the VES-13. CGA impairment was reported in 171 patients (66%). In the overall population, overall accuracy, sensitivity and specificity of CHS in identifying CGA impairments were 74%, 87% and 49%, respectively. The corresponding figures for the VES-13 were 68%, 62% and 81%. Sensitivity and specificity of CHS in predicting CGA impairments in subgroups were early 81% and 55%, advanced 98% and 29%; early breast 78% and 69%, early GI 87.5% and 19%. The CHS compared favourably with VES-13 for sensitivity. However, the great variability in specificity observed with the CHS within subgroups limits its applicability in the global population.

総胆管切開術後の胆道造影を契機に発見された非露出腫瘤型乳頭部早期癌の1例

総胆管切開術後の胆道造影を契機に発見された非露出腫瘤型乳頭部早期癌の1例

Is Autofluorescence Bronchoscopy Needed to Diagnose Early Bronchogenic Carcinoma?

Is Autofluorescence Bronchoscopy Needed to Diagnose Early Bronchogenic Carcinoma?

GASTRIC CANCER RETROSPECTIVELY INVESTIGATED FOR 9 YEARS AND 6 MONTHS: A CASE OF LINITIS PLASTICA

This report presents a rare case of a patient with gastric cancer whose clinical course with the development of tumor from early cancer type IIc to advanced cancer of linitis plastica was observed for 9.5 years. The cancer remained in early stage for 3 years and 8 months after the patient’s first endoscopy. At 5 years and 10 months after initial endoscopy, the lesion progressed to advanced cancer, and after 6 years and 7 months sclerotic changes in the gastric wall were detected at the lesion site. After 9 years, advanced gastric cancer of linitis plastica was present throughout the stomach. The initial stage of linitis plastica is considered to be early gastric cancer type IIc with histologically undifferentiated cancer cells. It is widely accepted that a period of 6–8 years is required for this type of cancer to develop from carcinogenesis to completion of lesions. The present case is valuable in that development from early gastric cancer type IIc to linitis plastica during approximately 10 years of follow up was clinically observed, and will contribute to knowledge of the natural history of gastric cancer.

A CASE OF DOUBLE PRIMARY CANCERS IN STOMACH AND LUNG

We have experienced an extremely rare case of double primary cancers in stomach and lung. An 87-year-old male underwent a subtotal gastrectomy due to double stomach cancers 4 years previously. The pathological report suggested double primary cancers: Borrmann 3 type, advanced cancer and a IIa + Iic type early cancer with different histological findings. This time, a infiltrative shadow in his right lower lung was detected y chest X-ray, and double tumor shadows were found in S4 and S10 by chest CT. TV brushing cytology from the tumor of S10 suggested a malignancy. Therefore, partial bi-lobectomy of the right middle and lower lobes was performed with the aid of a thoracoscope. Pathological examination revealed double primary lung cancers, because the tumor in S4 was papillary adenocarcinoma and the other was poorly differentiated squamous cell carcinoma. Therefore, this case was extremely rare because of the double primary cancers in both stomach and lung. We could not find any other clinical report abot such a case.

A Case of Depressed Type Early Duodenal Carcinoma Treated by Endoscopic Mucosal Resection

A case of depressed type early cancer in the 2nd portion of the duodenum is reported. A 52‐year‐old man underwent endoscopic examination, which revealed a depressed lesion in the 2nd portion of the duodenum, which was demonstrated by endoscopic biopsy to be borderline atypia. Endoscopic mucosal resection was performed. The resected specimen showed a rubescent irregular depression, 8 mm in size with marginal elevation. Histological examination revealed a well differentiated tubylar adenocarcinoma. The resected margins were cancer‐free. The stereoscopic image obtained from the resected specimen revealed a sulcus pattern on the margin of the noncancerous mucosa, which showed a demarcation with the cancerous mucosa and exhibited a zigzag pattern. This is the 12th case of depressed type early carcinoma of the duodenum reported in Japan. (Dig Endosc 1996 ; 8 : 231‐235)

Present Status of Early Colorectal Cancer in Japan

Abstract:We examined and clinicopathologically analyzed 422 patients with early colorectal cancer that we encountered, and discussed the problems typical of early colorectal cancers in Japan.In Japan we define early colorectal cancer as consisting of intramucosal cancer and cancer with submucosal invasion. Because histopathologists subjectively diagnose patients with intramucosal cancer, their diagnoses for the same specimen often differ from each other. The only way to avoid such confusion caused by diagnostic differences and to reach a consensus on the diagnosis of intramucosal cancer is to make a diagnosis of intramucosal cancer only in those patients who clearly show the structural atypia and/or the cellular atypia, that are typical of cancer.No one will deny the importance of the depressed type early cancer, the number of cases of which have recently been increasing in Japan. However, it is also important to assert that endoscopically‐discovered depressed neoplastic lesions are not always cancer. In the depressed neoplastic lesions discovered in our patients, the number of adenoma was almost three times that of cancer. Forty percent of the patients with depressed type early cancer also had an adenoma component. Therefore, at this moment we cannot conclude that early cancer with a depression is de‐novo‐genetic colorectal cancer.Eighty percent of early colorectal cancers are discovered to be the protruded type of early cancer. Twenty‐six percent of early cancers with submucosal invasion, including early cancers with massively submucosal invasion, are 6 to 10 mm in diameter and 76% of these are protruded early cancers. These facts indicate that colorectal tumors, protruded or depressed, which are more than 6 to 10 mm in diameter should be endoscopically removed to prevent them from becoming advanced cancers.

A CASE REPORT OF DEPRESSED TYPE EARLY CANCER OF THE SIGMOID COLON

Recently a case of depressed type early cancer of the sigmoid colon was experienced. A 57-year-old man without any chief complaints visited the hospital for minute examination, because he was pointed out on ulcerative lesion of the sigmoid colon at another hospital Colonoscopy showed a reddish depressed lesion with marginal elevasion in the sigmoid colon. Endoscopy showed that the lesion was a IIa+IIc type early colon cancer. The lesion was not considered a possible candidate for endoscopic polypectomy, and sigmoidectomy was performed. Resected specimen showed a depressed lesion, measuring 9×8mm, with marginal elevation and fold convergence macroscopically, although microscopically cancer cells invaded mucosa without any metastasis. Histological diagnosis was well differentiated adenocarcinoma. The cancer tissues were present partially in the marginal elevation but mostly in the depressed lesion.

Clinicopathological and Endoscopic Studies on Gastric Cancer Located; the Cardia

Abstract: In this study the definition of cardiac cancer (histologically adenocarcinoma) was taken to be a cancerous lesion, the size of which is less than 4 cm and the center of which is located within 2 cm from the esophagocardiac junction. 42 patients (0.8%) fit the above definition of cardiac cancer out of 4,958 patients with solitary gastric cancer operated on at the National Cancer Center Hospital daring the period between 1962 and 1988. The clinicopathological and endoscopic findings of these 42 patients were compared with those of 132 patients with gastric cancer located in the upper third of the stomach other than in the cardia (cancer in the other C‐area). In the group with cardiac cancer, the male patients (M/F ratio: 3.7), the elderly patients (mean age: 61.3 years), a differentiated type of adenocarcinoma (90%), lesions located at the lesser curvature (62%) and the elevated type of lesion were found to predominate. The incidence of early cancer (60%) and the incidence of small lesions less than 2 cm (32%) in diameter were lower than in the patients with cancers in the other C‐area. In the group with cardiac cancer, however, the incidence of such types of early cancer as the depressed lesion, a small lesion less than 2 cm in diameter and lesions difficult to diagnose endoscopically, have been increasing. In recent years, cardicac cancers have been found not only on the lesser curvature, but also in different areas of the cardia.These results suggest an improvement in endoscopic diagnosis for cardiac cancer. To make early detection more precise, it will be indispensable not to overlook even faint or indistinct mucosal abnormalities at the area adjacent to the esophagocardiac junction.

CLINICOPATHOLOGICAL STUDY OF GASTRIC CANCER IN YOUTH UNDER 39 YEARS

In terms of clinicopathological features of cases of gastric cancers as examined by age, the auther's investigations have confirmed that patients in their twenties and thirties hold biological properties in common. In this study, the authers examined the above patients as cases of juvenile gastric cancer and obtained the following results: Cases of juvenile gastric cancer represented 76 (9.2%) of a total of 827 resected cases, with sex ratio of 1:1. Of these 76 cases, 33 were all depressed type early cancers and 43 were advanced cancers with predominant IV type (15 cases). Juvenile 5-year-survival rate was 60.2%, which was practically equal to 59.3% for patients aged over 40 years. Curative resection was performed in 88.2% of the cases, 5-year-survival rate for which was 71.6%. Recurrence was noted in 13 curatively resected cases. Death occurred in 22 cases, 21 of which showed ps (+) as depth of penetration, and the cause was peritoneal dissemination in 19 cases.

銅蒸気レーザー励起色素レーザーによる光線力学的治療

HpD photodynamic therapy (PDT) on patients with early gastric cancer was performed endoscopically using a copper vapor-dye laser (CVL-DL). This pulsed dye laser made in Japan ( by Nippon Infrared Industries Company, NIIC) was equipped with an inner power-meter, a foot-switch for on-off of laser beam, and a timer for irradiation. The tip of a single quartz fiber was protected by a gentle flow of nitrogen gas from sticking of mucus. These devices enable us to accomplish PDT speedily. The mean output of the laser (5.5 kHz, 630nm) was 300 mW at the tip of the fiber.Two patients considered poor risks for surgery, one with 11c type and the other with 111+11c type early cancer, were successfully treated without any complication. PDT with CVL-DL seems to be more effective than that with an argon-dye laser.

Early adenocarcinoma of the gastric cardia.

The relationships of gross and histologic types of early gastric cancer in the upper portion of the stomach, the extent of the normal oxyntic gland area and the grade of intestinal metaplasia in the mucosa surrounding the tumor, to the distance of the tumor from the squamocolumnar junction were examined in 29 specimens obtained at total gastrectomy. There were significant correlations between gross type of early cancer, extent of the normal oxyntic gland areas or the grade of intestinal metaplasia in the surrounding mucosa, and the distance of the tumor from the squamocolumnar junction. Cancers located within 2 cm from the squamocolumnar junction were more frequently polypoid, more frequently associated with a large oxyntic gland area, and less commonly surrounded by profuse intestinal metaplasia. The above differences suggest that cancers located within 2 cm from the squamocolumnar junction differ from those in other regions of the upper portion of the stomach.

3. The Studies on Experimentally Induced Colonic Carcinoma in Dog by Selective Application of MNNG

There is no report of experimentally developed colon cancer in the dog up to date. In this paper, the experimental high grade atpyical glands of colon in dog which was expected to developed into adenocarcinoma was reported. Administration procedure of MNNG was as follows;The tip of silicon tube was fixed in the ascending colon through the vermiform appendix and the other end of tube was carried out to the back of the dog through the subcutaneous tunnel. Solution of MNNG with 3 g/1 tween 60 were injected through this tube twice a week in 8 dogs.The endoscopic examination were performed regularly in each dog after the start of administration of MNNG. The administration of MNNG were varied depending on the general condition of the dogs.In one dog which was underwent of administration of 2mgMNNG/kg for weeks and 1 mg/kg for 41 weeks, the endoscopy demonstrated the lesion similar to IIc+IIa, type of early cancer. Biopsy of the lesion revealed the atypical glands in deep mucosal layer.By autopsy, this lesion was confirmed as high grade atypical glands and protrusion of its glands into submucosal layer was proved histologically.

13. The Characteristics of the Early Cancer of the Lower Rectum and the Anus and its Treatment

Due to the specific anatomical location, the early cancer of the lower rectum and the anus characteristic features in its form, symptoms, diagnosis and surgical treatment.The epithelium of the area turns from the columnar epithelium of the rectal mucosa to the stratified cuboidal epithelium of the so-called cloacogenic zone, further to modified squamous epithelium of the anoderm and finally to stratified squamous epithelium of the perianal area. Various types of early cancer are to originate from those diversified epithelia.The early cancer of the area might be difined as those which is not exceeding more than the musculus submucosae ani.The early cancer of the area is relatively fixed well to the underlying tissues and is forced to be burshed by the passage of the stool so that it shows flatly elevated form withlittle mobility.Villous adenoma frequently is the precursor of the cancer.Its treatment should be decided deliberately on the basis of the pathological features of the tumor obtained by the total biopsy.It is because the radical operation the area inevitably sacrifices the total function of the sphincter.

Comparative study on histological changes around ulcer lesion and secretory function between peptic ulcer and ulcerative type of early cancer of the stomach

Peptic ulcer and early cancer of the stomach possessing ulcer lesion of similar size locating near angular incisure were compared concerning histological changes around ulcer lesion and secretory function with the following conclusions. In peptic ulcer the restriction in the development of ulcer size is accompanied by the relatively stationary localized mucosal atrophic changes around ulcer lesion, while in gastric carcinoma the advancement of carcinomatous ulcer lesion brings the development of mucosal atrophic changes around lesion in degree and extent. Such findings may be interpreted as the evidence that some part of mucosal atrophie changes around ulcer lesion are secondary to ulcer lesion and the nature of ulcer lesion decides the future course of atrophie changes, although such histological changes proceed unevenly from direction to direction with marked individual variation. As to secretory function of the stomach no essential difference was found in maximal acid output (MAO) and pepsin output after maximal stimulation between two clinical entities. The correlation was recognized between the degree and the extent of mucosal atrophie changes and the degree of secretory disturbance in each individual case.

Gastric Lymphosarcoma Limited to the Mucosa and Submucosa Simulating the Macroscopical Appearance of Early Cancer Type II c

Gastric Lymphosarcoma Limited to the Mucosa and Submucosa Simulating the Macroscopical Appearance of Early Cancer Type II c