Comparison of Clinicopathologic Findings between Colorectal Adenoma with High Grade Dysplasia and Colorectal Carcinoma with Mucosal Invasion

Korean J Gastrointest Endosc > Volume 25(6); 2002 > Article

Korean Journal of Gastrointestinal Endoscopy 2002;25(6): 438-442.

대장의 고도 이형성 선종과 점막암의 임상병리학적 비교

기명주·신현덕·김재덕·신정은·임창영

단국대학교 의과대학 내과학교실

Comparison of Clinicopathologic Findings between Colorectal Adenoma with High Grade Dysplasia and Colorectal Carcinoma with Mucosal Invasion

Myoung Joo Ki, M.D., Hyun Duk Shin, M.D., Jae Duk Kim, M.D.,Jeong Eun Shin, M.D. and Chang Young Lim, M.D.

Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Korea

Abstract

Background/Aims:
The precancerous lesion of colorectal cancer is adenoma. Adenoma with high grade dysplasia has been known as the lesion having high malignant potentials. The cancer with invasion to mucosa is limted to the mucosa, and it is difficult to pathologically differentiate the adenoma with high grade dysplasia.
Methods:
Fifty three adenomas with high grade dysplasia (type I group) and 40 cancers with invasion to mucosa (type II group) for 4 years, were analyzed for the colonoscopic findings and pathological findings before and after EMR.
Results:
Mean ages were 57.0 years old for type I group and 60.4 for type II group. Chief complaint for colonoscopy was rectal bleeding (21.0%) for type I group, and rectal bleeding (35.0%) for type II group. Mean sizes of the lesions were 1.18 cm for type I group, and 1.71 cm for type II group. Locations of the lesion were rectum 43.4%, sigmoid colon 32.1%, proximal colon 24.5% for type I group, and rectum 45.7%, sigmoid colon 42.9%, proximal colon 11.4% for type II group. Shapes of the lesions were Is 46.9%, Ip 30.6%, Isp 18.4%, LST 4.1% for type I group, and Isp 34.2%, Ip 31.6%, Is 18.4%, LST 5%, IIa⁢depression 5%, Is⁢IIc 5% for type II group.
Method
for therapy were EMR 60.4%, operation 1.9%, electrocoagulation 11.3%, observation 26.4% for type I group, and EMR 85.0%, operation 15.0% for type II group. Pathological agreement before and after EMR was 57.1% for type I group and 31.3% for type II group.
Conclusions:
Type II group had more rectal bleeding, larger, more Isp type, more EMR therapy, more pathological disagreement ratio before and after EMR, than type I group. (Korean J Gastrointest Endosc 2002;25:438⁣442)

Key Words: Colorectal adenoma with high grade dysplasia, Mucosal cancer

주요어: 대장 고도 이형성 선종, 점막암