直腸癌における壁内進展

概要

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A hundred and seventy one operative specimens of carcinoma of the rectum were evaluated distant intramural spread of carcinoma histologically along with proposed distal margin of resection. In this study, the distance (mm) form an exposed margin of carcinoma to the maximum extension toward the distal side was measured as an intramural spread.<BR>Intramural spread was divided histologically into two extension patterns ; one directly continuous and the other discontinuous through lymphatic permeation from the gross tumor. The intramural spread was limited within 10 mm from the lesion : 98.1% of localized gross type. 98.7 % of differentiated histological type and 100 % of all lesions limited to the rectal wall, and most of them showed directly continuous spread. Many cases of invasive gross type, undifferentiated histological type and invasive type involving extrarectal tissues, however, showed an extention over than 10 mm, exhibiting discontinuous spread through lymphatic permeation.<BR>Based on these findings, proposed distal margin of localized gross type, differentiated histological type and lesions limited to the rectal wall was considered to be 1 cm from the lesion.
日本大腸肛門病学会の論文