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Lymphknotenmetastasen bei Plattenepithelfrühkarzinomen des Ösophagus

Lymph node metastasis in superficial squamous carcinoma of the esophagus

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Zusammenfassung

Die Definition der Plattenepithelfrühkarzinome des Ösophagus hat sich im Laufe der Zeit geändert. Seit 2007 wird das Frühkarzinom als intramukosales Karzinom mit oder ohne Metastasen definiert. In der Subklassifikation der Invasionstiefe weisen mukosale m1- und m2-Plattenepithelkarzinome praktisch keine Metastasen auf und gelten als endoskopisch heilbar. Dagegen bilden 10% der m3-Karzinome und etwa 20% der sm1-Plattenepithelkarzinome Lymphknotenmetastasen aus. In der vorliegenden Arbeit wird die Beziehung zwischen verschiedenen histopathologischen Befunden bei m3- und sm1-Plattenepithelkarzinomen und dem Auftreten von Lymphknotenmetastasen bewertet. Nach der Paris-Klassifikation und der Größe werden endoskopisch folgende Typen unterschieden: 0-I- und 0-III-Typen sowie große Tumoren über 50 mm Größe. Tumoren mit Gefäßeinbrüchen weisen ebenfalls eine höhere Inzidenz von Lymphknotenmetastasen auf. Wichtig für Pathologen ist, dass von klinischer Seite in der Magen-Darm-Pathologie erwartet wird, dass histologisch nicht nur eine Malignitätsbewertung durchgeführt, sondern auch im Detail auf Risikofaktoren für Lymphknotenmetastasen eingegangen wird.

Abstract

The definition of early carcinoma of the esophagus has changed with time on the basis of new data. As from 2007 an early carcinoma is defined as an intramucosal carcinoma with or without metastasis. In the subclassification based on invasion depth, m1 and m2 squamous cell carcinomas have no metastasis and are considered curable by endoscopic resection alone, whereas less than 10% of m3 carcinomas and some 20% of sm1 squamous cell carcinomas have lymph node metastasis. In this article the relationship between various histopathological findings and the incidence of lymph node metastasis is reviewed. The m3 and sm1 superficial squamous cell carcinomas showing 0-I and 0-III types, large tumors over 50 mm in size or those showing vessel permeation have higher incidences of lymph node metastasis. In the field of gastrointestinal surgical pathology pathologists are now expected to not only diagnose the presence or absence of malignancy but also to investigate in detail many of the histological factors related to the prevalence of lymph node metastasis.

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Authors and Affiliations

  1. Research Team for Geriatric Pathology, Tokyo Metropolitan Institute of Gerontology, and Department of Pathology, Tokyo Metropolitan Geriatric Medical Center, Sakae-cho 35–2, Itabashi-ku, 173–0015, Tokyo, Japan

    K. Takubo, J. Aida & T. Arai

  2. Department of Surgery, Tokai University Hachioji Hospital, 192–0032, Hachioji City, Japan

    H. Makuuchi

  3. Department of Gastroenterology, Saitama Cancer Center, 362–0806, Ina-machi, Saitama-ken, Japan

    M. Arima

  4. Institut für Pathologie, Klinikum Bayreuth, Bayreuth, Deutschland

    M. Vieth

Authors
  1. K. Takubo
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  2. H. Makuuchi
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  3. M. Arima
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  4. J. Aida
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  5. T. Arai
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  6. M. Vieth
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Correspondence to K. Takubo.

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Takubo, K., Makuuchi, H., Arima, M. et al. Lymphknotenmetastasen bei Plattenepithelfrühkarzinomen des Ösophagus. Pathologe 34, 148–154 (2013). https://doi.org/10.1007/s00292-012-1730-5

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  • DOI: https://doi.org/10.1007/s00292-012-1730-5

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