A New Sub-classification of Superficial Colorectal Tumor and Early Cancer by Magnifying Colonoscopy.

概要

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Gross configuration of superficial colorectal tumor and early cancer is classified into superficially elevated (II a, II a + II c ), flat (II b) or depreessd (II c, II c + II a) types in Japan. These lesions of 38 cases were classified into three sub-groups according to the appearance of the border of the lesion using magnifying colonoscopy. 1) non-elevated (II b and II c without any elevation) ; 5 cases. In other types, there was an elevation of the border of the lesion. 2) magnifying colonoscopic polypoid growth type (MCPG (+)) ; 24 cases. A change in the pit pattern of the tumor was observed only on the elevated border of the lesion. 3) magnifying colonoscopic non-polypoid growth type (MCPG (-)); 9 cases. A change in the pit pattern was observed inside the elevated border of the lesion. In the non-elevated group, 5 lesions were completely limited in the mucosa. Among 24 MCPG (+) lesions, 21 were limited in the mucosa and 3 were submucosal cancers. In the MCPG (-) group, there were 8 submucosal cancers and one advanced cancer that infiltrated to muscularis propria. The sensitivity, specificity and accuracy in diagnosing the submucosal invasion were 75%, 100%, and 92%, respectively. These results suggest that this sub-classification by magnifying colonoscopy is useful to distinguish submucosal invasive lesion from mucosal lesion.