Korean J Gastrointest Endosc > Volume 22(6); 2001 > Article

Korean Journal of Gastrointestinal Endoscopy 2001;22(6): 411-418.

대장 점막하 침윤암의 림프절 전이의 위험인자 : 심달도 분류를 중심으로 ( Risk Factors of Lymph Node Metastasis in Submucosally Invasive Colorectal Carcinoma : with Special Reference to the Depth of Invasion )

정성애(Sung Ae Jung),양석균(Suk Kyun Yang),강경훈(Gyeong Hoon Kang),명승재(Seung Jae Myung),유혜승(Hae Seung Yu),원선영(Sun Young Won),심기남(Ki Nam Shim),정훈용(Hwoon Yong Jung),김희철(Hee Cheol Kim),유창식(Chang Sik Yu),김진천(Jin Cheon Kim),홍원선(Weon Seon Hong),김진호(Jin Ho Kim),민영일(Young Il Min)

Abstract

Background/Aims:
It has been reported that lymph node (LN) metastasis occurs in approximately 10 percent of patients with submucosally invasive colorectal carcinoma. The present study was performed to determine the clinical significance of absolute and relative depth of submucosal invasion and to find the associated pathological risk factors of LN metastasis in submucosally invasive colorectal carcinoma.
Methods:
From June, 1989 to May, 1999, 2,580 patients were pathologically confirmed as having colorectal carcinoma, Of these patients, a total of 61 subjects with submucosally invasive carcinoma could be reviewed pathologically and were included in this retrospective analysis. The relative depth of submucosal invasion was evaluated by Kudo (sm1, 2, 3) and modified Haggitt (L1, 2, 3) classifications, and the absolute depth was measured,
Results:
The absolute depth of submucosal invasion was significantly correlated with the relative depth evaluated by both Kudo and modified Haggitt classifications (p<0.01). Of 51 patients in whom the status of LN metastasis could be evaluated, six (11.8%) showed LN metastasis, Among the patients with LN metastasis, there was no one with sm1or L1in the relative depth and 500 ㎛or less in the absolute depth. The risk of LN metastasis was related to the gross type, and lymphatic or vessel invasion (p <0.05).
Conclusions:
The risk factors for LN metastasis in submucosally invasive colorectal carcinoma were the gross type and lymphatic or vessel invasion, The results also suggest that the absolute depth of submucosal invasion might be a useful parameter to select the patients for the endoscopic treatment, (Korean J Gastrointest Endosc 2001;22:411- 418)

Key Words: 조기 대장암 , 내시경적 절제술 , 점막하 침윤암 , 심달도 , Early colorectal cancer , Endoscopic treatment , Submucosal invastion