| 원발성 대장 인환세포암의 임상 및 내시경 특성 |
| 표성희·변정식·명승재·양석균·이형준·표승일·김진호·김진천*·장세진† |
| 울산대학교 의과대학 서울아산병원 내과, *외과, †진단병리과 |
| Clinical and Colonoscopic Characteristics of Primary Signet Ring Cell Carcinoma in Colorectum |
| Sung Hee Pyo, M.D., Jeong-Sik Byeon, M.D., Seung-Jae Myung, M.D., Suk-Kyun Yang, M.D., Hyung Joon Lee, M.D., Seung Il Pyo, M.D., Jin-Ho Kim, M.D., Jin Cheon Kim, M.D.* and Se Jin Jang, M.D.† |
| Departments of Internal Medicine, *Surgery and †Diagnostic Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea |
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| Abstract |
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Background/Aims:
A primary signet ring cell carcinoma (SRCC) in the colorectum is unusual. This study evaluated the clinical and colonoscopic characteristics of primary colorectal SRCC.
Methods:
Twenty-eight patients diagnosed with a primary colorectal SRCC and 100 patients diagnosed with a primary colorectal nonmucinous adenocarcinoma were enrolled in this study. The medical records and colonoscopic findings were reviewed.
Results:
The mean age was younger in the SRCC patients than in the nonmucinous adenocarcinoma patients (47.3±15.5 years vs. 60.3±10.4 years, p＜0.001). In SRCC, hematochezia was less frequent while abdominal pain was more common (p＜0.001). Duke stages A or B was rare in SRCC (4/28, 14.3% vs. 58/100, 58.0%, p＜0.001). The colonoscopic features of Borrmann type 4 was more common in SRCC (10/28, 35.7% vs. 3/100, 3.0%, p＜0.001). The occurrence of a tumor in the right colon was more frequent in SRCC (17/28, 60.7% vs. 20/100, 20.0%, p＜0.001). The diagnostic yield of the first colonoscopic biopsy was lower in the SRCC patients (85.7% vs. 98.0%, p=0.021).
Conclusions:
Primary colorectal SRCC appears to occur in younger patients compared with nonmucinous adenocarcinoma. A more advanced stage and an infiltrative lesion such as Borrmann type 4 appears to be common and the diagnostic yield of a colonoscopic biopsy tends to be low in primary colorectal SRCC. (Korean J Gastrointest Endosc 2006;33:278284) |
| Key Words:
Signet ring cell carcinoma, Colorectal adenocarcinoma, Colonoscopy, Biopsy |
| 주요어:
인환세포암, 대장 선암, 대장내시경, 조직 생검 |
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