BACKGROUND Although small colorectal neoplasms(<10 mm)are often easily resected endoscopically and are considered to have less malignant potential compared with large neoplasms(≥10 mm),some are invasive to the sub...BACKGROUND Although small colorectal neoplasms(<10 mm)are often easily resected endoscopically and are considered to have less malignant potential compared with large neoplasms(≥10 mm),some are invasive to the submucosa.AIM To clarify the clinicopathological features of small T1 colorectal cancers.METHODS Of 32025 colorectal lesions between April 2001 and March 2018,a total of 1152 T1 colorectal cancers resected endoscopically or surgically were included in this study and were divided into two groups by tumor size:a small group(<10 mm)and a large group(≥10 mm).We compared clinicopathological factors including lymph node metastasis(LNM)between the two groups.RESULTS The incidence of small T1 cancers was 10.1%(116/1152).The percentage of initial endoscopic treatment in small group was significantly higher than in large group(<10 mm 74.1%vs≥10 mm 60.2%,P<0.01).In the surgical resection cohort(n=798),the rate of LNM did not significantly differ between the two groups(small 12.3%vs large 10.9%,P=0.70).In addition,there were also no significant differences between the two groups in pathological factors such as histological grade,vascular invasion,or lymphatic invasion.CONCLUSION Because there was no significant difference in the rate of LNM between small and large T1 colorectal cancers,the requirement for additional surgical resection should be determined according to pathological findings,regardless of tumor size.展开更多
Endocytoscopy is a next-generation endoscopic system that facilitates real-time histopathologic endoscopic diagnosis of colorectal lesions by virtue of its 520×maximum magnification.CASE SUMMARY We present the ca...Endocytoscopy is a next-generation endoscopic system that facilitates real-time histopathologic endoscopic diagnosis of colorectal lesions by virtue of its 520×maximum magnification.CASE SUMMARY We present the case of a 63-year-old man with sigmoid colon cancer who was regularly referred for follow-up colonoscopy after endoscopic resection of T1 rectal cancer.Colonoscopy revealed a 12 mm reddish polyp,including a depression and a flat area in the sigmoid colon.Endocytoscopic observation showed unclear gland formation and agglomeration of distorted nuclei(depression),suggesting a submucosal invasive(T1)cancer.In the flat area,slitlike smooth lumens and regular pattern of fusiform nuclei were found,suggesting an adenoma.On the basis of these endocytoscopic findings,we predicted this lesion as T1 cancer(depression)with adenoma(flat area)and performed endoscopic resection corresponding to the final histopathological diagnosis.CONCLUSION We could perform an optical diagnosis of T1 sigmoid cancer with adenoma by using endocytoscopy before treatment.展开更多
文摘BACKGROUND Although small colorectal neoplasms(<10 mm)are often easily resected endoscopically and are considered to have less malignant potential compared with large neoplasms(≥10 mm),some are invasive to the submucosa.AIM To clarify the clinicopathological features of small T1 colorectal cancers.METHODS Of 32025 colorectal lesions between April 2001 and March 2018,a total of 1152 T1 colorectal cancers resected endoscopically or surgically were included in this study and were divided into two groups by tumor size:a small group(<10 mm)and a large group(≥10 mm).We compared clinicopathological factors including lymph node metastasis(LNM)between the two groups.RESULTS The incidence of small T1 cancers was 10.1%(116/1152).The percentage of initial endoscopic treatment in small group was significantly higher than in large group(<10 mm 74.1%vs≥10 mm 60.2%,P<0.01).In the surgical resection cohort(n=798),the rate of LNM did not significantly differ between the two groups(small 12.3%vs large 10.9%,P=0.70).In addition,there were also no significant differences between the two groups in pathological factors such as histological grade,vascular invasion,or lymphatic invasion.CONCLUSION Because there was no significant difference in the rate of LNM between small and large T1 colorectal cancers,the requirement for additional surgical resection should be determined according to pathological findings,regardless of tumor size.
文摘Endocytoscopy is a next-generation endoscopic system that facilitates real-time histopathologic endoscopic diagnosis of colorectal lesions by virtue of its 520×maximum magnification.CASE SUMMARY We present the case of a 63-year-old man with sigmoid colon cancer who was regularly referred for follow-up colonoscopy after endoscopic resection of T1 rectal cancer.Colonoscopy revealed a 12 mm reddish polyp,including a depression and a flat area in the sigmoid colon.Endocytoscopic observation showed unclear gland formation and agglomeration of distorted nuclei(depression),suggesting a submucosal invasive(T1)cancer.In the flat area,slitlike smooth lumens and regular pattern of fusiform nuclei were found,suggesting an adenoma.On the basis of these endocytoscopic findings,we predicted this lesion as T1 cancer(depression)with adenoma(flat area)and performed endoscopic resection corresponding to the final histopathological diagnosis.CONCLUSION We could perform an optical diagnosis of T1 sigmoid cancer with adenoma by using endocytoscopy before treatment.
