The elucidation of the evolution and progression of early colorectal carcinomas by the genetic alteration.

1.早期结直肠癌治疗方法的选择，尤其是内镜下治疗的适应证的确定，是临床上的一个重要问题。无淋巴结转移的浅表性结直肠癌绝对适用于内镜治疗。考虑到先前的报告，EMR适用于残留在粘膜中的肿瘤或轻微侵入粘膜下层的癌症。因此，我们评估了常规、染色体、放大结肠镜和超声内镜对早期大肠癌浸润深度分期的诊断价值.通过手术或内镜黏膜切除术获得的石蜡包埋组织进行遗传学改变的分析。近年来，微卫星不稳定性与大肠癌的临床意义被大量报道。从另一个角度评价微卫星不稳定性的结果，认为改变的微卫星描述了肿瘤进展的遗留问题。因此，微卫星改变的发现可能有助于阐明早期大肠癌的演变和发展。我们分析了四种不同分化程度的早期大肠癌的微卫星改变。改变的微卫星表明，在这种情况下，存在两种癌症的演变和进展途径。认为微卫星改变分析对阐明早期大肠癌的发生、发展具有重要意义。因此，有必要对大量早期大肠癌进行微卫星改变分析。

1. Studies in patients with early colorectal carcinomaThe selection of a therapeutic method for early colorectal carcoinomas, especially determination of the indication of endoscopic treatment for this cancer, is a clinically important. Cases of superficial colorectal cancer without lympho node metastasis are absolutely indicated for endoscopic treatment. Considering the previous reports that EMR is indicated in cases of tumors remaining in the mucosa or cancer slightly invading the submucosal layer. Therefore, we evaluated the diagnostic efficacy of the conventional, chromo, magnified colonoscopy, and endoscopic ultrasound sonography for the staging of invasive depth of early colorectal carcinomas.2. The analysis of genetic alteration using the paraffin-embedded tissues obtained by surgical or endoscopic mucosal resection.Recently, a lot of clinical significance between microsatellite instability and colorectal carcinomas were reported. On evaluating the results of microsatellite instabilitly from another point of view, it is thought that the altered microsatellites described a legacy of tumor progression. Therefore, the findings of microsatellite alteration may contribute to the elucidation of the evolution and progression of early colorectal carcinomas. We analyzed microsatellite alteration in an early colorectal carcinoma with four different grades of differentiation. The altered microsatellites suggested that two pathways of evolution and progression of carcinomas were present in this case. It was thought that the analysis of microsatellite alteration was very useful method for the elucidation of the evolution and progression of early colorectal carcinomas. It is necessary to investigate the analysis of microsatellite alteration in many cases with early colorectal carcinomas.