Image Analyzer Studies on Lymph Node and Hematogenous Metastases in Relation to Growth Appearance and Degree of Invasion in Patients with Colorectal Cancer Invading the Muscularis Propria

Sotaro Sadahiro, Masaya Mukai, Hideki Ishida, Nobuhiro Tokunaga, Tomihiko Kimura, Toshiyuki Suzuki, Hirotada Iwase, Kenji Ishikawa, Tomoo Tajima, Toshio Mitomi

Department of Surgery II, Tokai University School of Medicine

To ascertain the risk factors of metastasis, 102 patients with colorectal cancer invasing the muscularis propria were examined in terms of growth appearance and degree of invasion with an image analyzer. Type 1 tumors were larger in diamter in the mucosa and in overall tumor area than type 2 tumors. The deeper the invasion, the larger were the diameter and area of the tumor in the muscularis propria, but there was no relationship between the degree of invasion and either the tumor diameter or area in the mucosa. Thus no relationship was recognized between tumor diameter and degree of invasion in patients with colorectal cancer invading the muscularis propria. Although the presence or absence of metastasis to lymph node had no relation to the growth appearance and tumor area in the muscularis propria, the tumor area in the muscularis propria was usually small in patients with hematogenous metastasis (p=0.018) and the ratio of the tumor area in the muscularis propria to the overall tumor area was lower (p<0.01) than in patients without hematogenous metastasis. The frequency of hematogenous metastasis decreased with increasing degree of invasion, but the difference was not significant. These results suggest that it is difficult to predict metastasis from either the growth appearance or the degree of invasion in patients with colorectal cancer invading the muscularis propria. Rather, it is worth noting that the frequency of hematogenous metastasis is higher in patients with mild degree of invasion.

Key words
colorectal cancer, image analysis, lymph node metastasis, hematogenous metastasis

Reprint requests
Sotaro Sadahiro Department of Surgery, Tokai University School of Medicine
Bohseidai, Isehara, 259-11 JAPAN

Accepted
October 9, 1996

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