Reflection upon the detectability of early esophageal carcinoma at the initial radiological examination
Yamaki G.; Et Al
Stomach and Intestine 25(1): 13-25
ISSN/ISBN: 0536-2180 Accession: 007731452
Early carcinoma of the esophagus is defined as carcinoma which is limited to the submucosa (sm-ca.) without lymph node metastasis, and superficial carcinoma is defined as that which is limited to the submucosa regardless of whether or not there is lymph node metastasis. These two types of carcinoma have the same depth of invasion, but it has been found that this categorization is not completely suitable. Considering the fact that there is an unfavorable prognosis for sm-ca., it is desirable that a more clearly delineated definition of sm-ca. (early carcinoma) showed be formulated. We propose two types in place of the sm-ca. type. 1) The type limited to the epithelium (ep-ca.), and 2). The type invading the muscularis mucosae (mm-ca.). In the last 16 years, forty-three cases with 52 lesions of ep-ca. and mm-ca. have been detected and resected in our hospital. Most of the elevated type of ep-ca. and mm-ca. were detected by the radiological examination. On the other hand, in the depressed type, all cases of the ep-ca. and half of the cases of mm-ca. were overlooked. In the p-ca., a minimum degree of poor distensibility, and irregularity of the margin were visualized on a profile view with slight esophageal distension. These marginal abnormalities were effaced in moderate esophageal distension. However, mm-ca. types were not effected by a changing degree of esophageal distension. It was suggested that mm-ca. could be detected in the initial radiographic examination through meticulous interpretation.