| Project/Area Number |
08671484
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Digestive surgery
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| Research Institution | Tokai University |
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Principal Investigator |
MAKUUCHI Hiroyasu Tokai University, Department of Medicine.Professor, 医学部, 教授 (80095645)
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| Co-Investigator(Kenkyū-buntansha) |
CHINO Osamu Tokai University, Department of Medicine.Assistant Professor, 医学部, 助手 (00246117)
SHIMADA Hideo Tokai University, Department of Medicin.Assistant Professor, 医学部, 助手 (40206173)
水谷 郷一 東海大学, 医学部, 助手 (60209757)
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| Project Period (FY) |
1996 – 1997
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| Project Status |
Completed (Fiscal Year 1997)
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| Budget Amount *help |
¥2,600,000 (Direct Cost: ¥2,600,000)
Fiscal Year 1997: ¥1,200,000 (Direct Cost: ¥1,200,000)
Fiscal Year 1996: ¥1,400,000 (Direct Cost: ¥1,400,000)
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| Keywords | Esophageal Cancer / Endoscopic Mucosal Resection / Lymph Node Metastasis / Superficial Esophageal Cancer / Factor VIII / Ki67 / Endoscopic Diagnosis / EMR / 内視鏡 / 食道粘膜癌 |
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| Research Abstract |
Along with the increase in discovery of early and superficial esophageal cancer, the endoscopic mucosal resection (EMR) has become a treatment widely performed for esophageal mucosal cancer in Japan. While the cancer limited in epithelium (m1) and in the proper mucosal layr (m2) are all indicated to EMR because they have no lymph node metastasis, the cancer invading to muscularis mucosae (m3) and shallow layr of submucosa (sm1) have also only 10 to 15% of lymph node metastasis.
We analyzed the patients of m3 and sm1 to investigate which lesions of these can also be treated by EMR without problems considering the operative invasiveness and post operative quality of life. Total of 124 cases of m3, sm1 esophageal cancer from various hospitals of Japan were subjected to the study to investigate the features without lymph node metastasis after analyzing the endoscopic figures, resected specimens and pathology.
Lymph node metastasis was occasionally observed in the mixed type of protrusion and
… More
depressed, poorly differentiated type, the lesion of INF gamma ly (+). Then, such lesions larger than 4cm of diameter or of 0-I,0-III,0-IIa+IIc appearance should be operated by surgery. The other types of such lesions should be performed EMR to investigate its pathology to be operated in case of moderately differentiated, INFbeta, ly (+) type and moderately differentiated, INF gamma type and poorly differentiated type, but only to be followed up in case of the other types. 58.9% of m3・sm1 cancer patients can avoid the operation in this way.
The observation of factor-8 in the superficial esophageal cancer indicated the neovascularity of cancer surrounding tissue beginning from m3, and the significant relationship between factor-8 staining and lymph node metastasis was observed.
The observation of MIB-1 of Ki-67 for the proliferation of superficial esophageal cancer revealed the sudden increase of Labeling Index (LI) from m3 to show the high proliferation in this layr. LI of MIB-1 indicated the significant relationship with lymphatic invasion and lymph node metastasis.
Further studies are to be accumulated in order to develop the minimally invasive treatment of esophageal cancer. Less
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