1. 気管食道科における早期癌の病理診断上の問題点

抄録

The early cancers should be curable ones and include not only non-invasive (carcinoma in situ) but also invasive ones without wide extension. The definition of the “early cancer” should be changed with the advancement of diagnostic accuracy and therapy. In this section, important points for histological diagnosis were mentioned in order to inform attending doctors most accurately of state of the tumor concerned. The early invasive cancers derived from originally stratified squamous epithelium can often be diagnosed only at the basostromal area of the tissue. Thus, the biopsy specimens should often contain baso-stromal area for the diagnosis of early lesion. Radial intraepithelial spread of advanced cancers is the rule and should be differen tiaed from true intraepithelial cancer (CIS) . Severely dysplastic lesions should be discussed between clinicians and pathologists on the next procedures to be taken. Some intraepithelial cancers can spread deeply via the ducts of accessory glands. Some cancers, for example, small cell carcinomas of the esophagus at the early stage, may not occasionally be early cancers because of their own high malignancy. The multiplicity of cancers at early stages can exist and should be recognized by clinicians and pathologists in the bronchoesophageal field. They may be related to “field carcinogenesis”.