A Review of the Pathological Issues of Endoscopic Resection for Early Colorectal Carcinomas

概要

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In this review, we present recent topics on the assessment of the pathological diagnosis for early colorectal carcinoma resected by endoscopy. Our conclusions were as follows: 1) handling of resected specimens is very important: fixation and sectioning, 2) depth of tumor invasion: when invasive SM colorectal carcinomas are divided into SM1 (depth of SM invasion is less than 1000μm) and SM2 (depth of SM invasion is 1000μm or more), lymph node metastasis was found in more than 30% of SM2 cases with positive budding/sprouting, 3) sessile serrated adenoma/polyp (SSA/P) with distinct molecular abnormalities: high frequency of DNA methylation at CpG islands and BRAF-mutations, rather than K-ras was a new precancerous lesion in the serrated-neoplastic pathway, 4) analysis of ER gene methylation and the DNMT-1 marker are useful for identifying individuals at increased risk of neoplasia among those with longstanding and extensive UC, but we stress the specific morphology of dysplasia, which is different from that of sporadic adenoma.