びまん浸潤型大腸癌の臨床病理学的検討

概要

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We studied the clinicopathological characteristics of 16 patients with diffusely invasive colorectal cancer, which accounts for 0.7% of all colorectal cancer. There were nine males and seven females with a mean age of 49 years. Five patients had moderately differentiated adenocarcinoma, five had poorly differentiated adenocarcinoma, and six had mucoid carcinoma. The depth of invasion was at least s (a2) in all cases. Severe lymphatic invasion of at least ly2 was found in 13 cases (81%). The progression of the tumor was classified into two patterns. Mucoid carcinoma or poorly differentiated adenocarcinoma did not show mucosal ulceration but showed diffuse spread below the submucosal layer. Whereas moderately differentiated adenocarcinoma showed small mucosal ulcers and massive lymphatic invasion. Of the 16 patients, 11 patients were classified Stage 4 or Stage 5. Curability was 25 %. Seven patients had recurrent tumor in the liver, 3 patients had peritonized dissemination, 2 patients had local recurrence. Among the 4 patients who had curative resection, 1 patient survived for over 5 years, 1 patient survived for over 2 years, 1 patient died of local recurrence 3 years later, and 1 patient died of a cause later unrelated to the disease 15 months.
日本大腸肛門病学会の論文