Early Cancer of the Gastrointestinal Tract (eBook)

Foreword 5
Preface 9
Contents 10
List of Authors 11
I. Case Presentations: Clinical Data, Endoscopy, and Pathology 14
1. Introduction 15
2. Early Cancer of the Stomach (Cases 1–12) 16
3. Early Cancer of the Colorectum (Cases 13–19) 75
4. Superficial Carcinoma of the Esophagus (Cases 20–24) 107
5. Comments on the Variability of the Diagnoses 133
II. Vienna Consensus Criteria for Pathological Diagnosis 135
1. Introduction 136
2. Basis for Discrepancies 136
3. Which Approach is Correct—East or West? 138
4. Utility of the Vienna Classification 139
5. Limitations of the Vienna Classification 139
6. Conclusion 140
III. Early Neoplasia in Barrett’s Esophagus 142
1. Introduction 143
2. How Histology Helps to Improve the Endoscopic Diagnosis of Early Neoplasia in Barrett’s Esophagus 143
3. Endoscopic Findings in Early Neoplasia in Barrett’s Mucosa 145
4. Histology of Early Neoplasia 146
5. Differential Diagnosis Between Regenerative Changes and Low-Grade Dysplasia in Barrett’s Mucosa 146
6. Differential Diagnosis Between Low-Grade and High-Grade Intraepithelial Neoplasia of Barrett’s Mucosa 147
7. Differential Diagnosis Between High-Grade Intraepithelial Neoplasia and Adenocarcinoma in Barrett’s Mucosa 147
8. Is Endoscopic Resection Adequate Treatment for Early Neoplasia of Barrett’s Mucosa? 149
9. Results of Surgical Treatment of Early Neoplasia of Barrett’s Mucosa 150
10. Different Endoscopic Resection Techniques 150
11. Endoscopic Resection of Early Neoplasia in Barrett’s Esophagus 151
IV. Detection of Early Cancer: Is Endoscopic Ultrasonography Effective? 157
1. Gastric Cancer 158
1. Introduction 158
2. Endoscopic Diagnosis 158
3. Chromoscopy 162
4. Pitfalls of Biopsy Diagnosis 162
5. Magnifying Endoscopy 163
6. Narrow Band Imaging 163
7. Endoscopic Ultrasonography (EUS) 163
2. Colorectal Cancer 164
1. How to Detect Early Colorectal Cancer 164
2. Significance of Endoscopic Ultrasonography (EUS) in the Management of Early Colorectal Cancers 164
3. Practical Aspects of Penetration Depth Diagnosis by EUS 165
3. Esophageal Cancer 169
1. How to Detect Early Esophageal Cancer 169
2. Endoscopic Ultrasonography (EUS) in Early Esophageal Cancer 172
4. Gastrointestinal Tract Cancer in Europe 175
1. Introduction 175
2. Diagnosis 175
3. Pathology 176
4. EMR Methods 176
5. Discussion 176
5. New Trends in Endoscopic Ultrasonography 179
1. Introduction 179
2. How to Detect Early GI Carcinoma 179
3. Is Endoscopic Ultrasonography (EUS) Effective? 179
4. Magnifying Endoscopy 180
5. Endoscopic Optical Coherence Tomography 184
6. Diagnosis of Early GI Tract Carcinoma in the Future 185
V. Endoscopic Treatment 187
1. Gastric Cancer 188
1. Introduction 188
2. Indication 188
3. Choice of Procedure: Endoscopic Mucosal Resection 188
4. Evaluation of the Procedure 189
5. Results 190
7. Extended Indications for Endoscopic Treatment 190
8. Problems of Endoscopic Treatment 190
9. Conclusion 190
2. Colorectal Cancer 192
1. Introduction 192
2. Indications for Endoscopic Treatment 192
3. Recognition of sm-Massive Cancers 192
4. Colonic EMR 193
5. Complications 194
6. Indications for Additional Surgery after EMR 195
7. Follow-Up after EMR 195
8. Summary and Future Prospects 195
3. Management of Colorectal Cancer by “Hot Biopsy” and Snare Resection 197
1. Introduction 197
2. “Hot Biopsy” for Colorectal Cancer 197
3. Snare Resection for Colorectal Cancer 198
4. Esophageal Cancer: Photodynamic Therapy 202
1. Early Neoplastic Lesions in the Esophagus 202
2. Principles of Photodynamic Therapy 202
3. Photosensitizers 203
4. Tissue Target 203
5. Laser Sources 204
6. Operative Procedure 204
7. Results of Endotherapy with PDT 205
8. Complications 206
9. Indications for PDT in Early Esophageal Cancer 206
5. Esophageal Cancer:Endoscopic Mucosal Resection 208
1. Early Esophageal Cancer and Endoscopic Mucosal Resection 208
2. Methods of EMR 208
3. EEMR-Tube 4-Step Method [4] 208
4. Indications for EMR 209
5. Results of EMR 211
6. Endoscopic Mucosal Resection for Barrett’s Adenocarcinoma 213
VI. Natural Course of Early Cancer 215
1. Gastric Cancer 216
1. Introduction 216
2. Growth Rates and Types of Gastric Cancer 216
3. Rapid-Growing Gastric Cancer 216
4. Slow-Growing Gastric Cancer 217
5. Progress from Early to Advanced Cancer 218
6. Conclusion 220
2. Colorectal Cancer: Retrospective, Prospective, and Histologic Observations 222
1. Introduction 222
2. Methods of Study 222
3. Natural Course of Polypoid Lesions 222
4. Natural Course of Nonpolypoid Lesions 226
5. Conclusions 227
3. Colorectal Cancer: Ulcerative Colitis-Associated Neoplasia 229
1. Introduction 229
2. How to Detect UC-Associated Dysplasia and Early Cancer Endoscopically 229
3. How to Discriminate UC-Associated Dysplasia from Inflammatory Regenerative Epithelium Pathologically 229
4. How to Identify Individuals at Increased Risk of Neoplasia, Especially Dysplasia, in Patients with Long-Standing and Extensive UC 232
4. Colorectal Cancer: The Importance of Depressed Lesions in the Development of Colorectal Cancer 234
1. Introduction 234
2. Gross Appearance of Early Colorectal Neoplasm 234
3. Differences Between Depressed Lesions and Slightly Elevated Adenomas 235
3. Differences Between Depres Theory and De Novo Theorysed Lesions and Slightly Elevated Adenomas 236
5. Development of Colorectal Cancer: From Polypoid to Ulcerated, or from Depressed to Elevated? 236
6. Genetic Alterations in Colorectal Tumorigenesis 237
5. Natural Course of Squamous Cell Carcinoma of the Esophagus 239
1. Overview of Growth and Development of Esophageal Cancer 239
2. Gross Findings of Super..cial Esophageal Cancer 239
3. Minute Cancers as Initial Cancer of the Esophagus 239
4. Development from Minute Cancers 239
5. Growth and Development from Mucosal Cancer to Submucosal Cancer 241
6. Natural Course of Esophageal Cancer 244
7. Summary of Growth and Development of Esophageal Squamous Cell Cancer 244
VII. Surgical Treatment and Survival Rate of Early Cancer 246
1. Surgical Treatment and Survival Rate of Early Cancer 247
1. Early Gastric Cancer 247
2. Early Esophageal Cancer 255
3. Early Colorectal Cancer 256
Index 261