The pathological type of cancer and diffusion, (a) pathology
1. Gross type
Colorectal cancer confined to attacks on the film and Mongolia, said membrane layer in early colon cancer . Early colorectal cancer without lymph node metastasis general, when the tumor invasion to Mongolia when the lower membrane, 5% _10% of the cases of local lymph node metastases. Colorectal Cancer Study Group of repeated studies to determine the pathological classification as follows:
(1) uplift type: All tumors were the main highlights to the intestine are of this type. Tumors were nodular, polypoid, cauliflower-like or grass-like. Tumor large, easy to form the surface of ulcer bleeding, infection and necrosis. Occurred in the right colon and rectum ampulla. Invasive low, the prognosis is good. Microscopic findings for the differentiation and maturation of many adenocarcinoma.
(2), ulcerative: Where the tumor surface were significantly deeper ulcer (ulcer or more than the general depth of muscle) are this type. According to ulcer appearance and growth of the limitations can be divided into ulcerative and infiltrative ulcerative. Ulcerative most common, accounting for more than half of colorectal cancer, characterized by a deeper and larger mass ulcer, form the craters, the edge of the hard uplift, the bottom of the grievance, necrosis, and high malignancy, early lymph node metastasis, microscopic as poorly differentiated adenocarcinoma.
(3) invasive: diffuse infiltration of tumor to the bowel wall layers, so that local wall thickening, but the surface is often no obvious ulcer or uplift. Intestinal tumor often involved the week, with fibrous dysplasia, significantly reduced intestinal circumference, forming a narrow ring, where serosa often be seen pulling the formation of fibrous tissue due to the narrow ring. Therefore, easily lead to obstruction, the proximal intestine may be extremely expansion-prone fecal colitis, diarrhea and constipation caused by a typical turn of this type is most common in the upper part of the sigmoid colon and rectum, malignant high transfer earlier. The rigid endoscope for the low differentiation adenocarcinoma.
19-64 Cancer Hospital, Sun Yat-sen "- '2003 radical resection specimens of 3165 cases of colorectal cancer. Protruding 1,031 cases, 32.6%, ulcerative 1,921 cases, accounting for 60.7%, 213 cases of infiltrating 6.7%.
And the spread of the pathological type of cancer 2. Histology
Colorectal epithelial cancer: papillary adenocarcinoma; tubular adenocarcinoma; Mongolia fluid adenocarcinoma; signet ring cell carcinoma; undifferentiated carcinoma; adenosquamous carcinoma; squamous cell carcinoma; carcinoid tumor.
Anal canal cancer: squamous cell carcinoma; type of basal cell carcinoma (Point Hong proto); mucoepidermoid carcinoma P adenocarcinoma; undifferentiated carcinoma; malignant melanoma. Although many classification, colorectal adenocarcinoma, accounting for more than 90%.
(B) of the diffusion pathway
(1) local spread: First, intramural spread of cancer around the wall one week about 2 years growth, carcinoma invasion to the muscle after the prone metastasis. Cancer that can attack the intestinal wall surrounding organs (such as bladder, prostate, uterus, small intestine, liver, stomach, film).
(2) lymph node metastasis: 60%. Colon cancer cells by the lymphatic network of Mongolia through the membrane lower surface of the intestinal wall intestinal wall colon lymph node lymph node lymph node intermediate the central lymph node (master node) para-aortic lymph nodes supraclavicular lymph nodes. Lymphatic cancer cells along the intestinal wall intestinal lymph nodes sigmoid rectal artery or inferior mesenteric artery lymph node artery lymph nodes aortic lymph node supraclavicular lymph nodes.
(3) hematogenous metastasis: 34%, metastasis to the liver, secondary to the lung, once again, bone, brain, ovary. Rarely transferred to the adrenal gland and kidney.
The pathological type of cancer and spread (4) metastasis: cancer cells grown in the abdominal cavity and basin off the formation of peritoneal nodules.