CLINICAL ANALYSIS FOR 148 CASES OF COLORECTAL ADENOMA WITH MALIGNANT CHANGE / 中国癌症杂志

ABSTRACT

PURPOSE In order to correct the wrong point of view which considered the colorectal adenoma with malignant change as early stage of carcinoma or as carcinoma with low grade malignancy and to avoid performing simple operation unreasonably. METHODS 148 cases of colorectal adenoma with malignant change which were treated in our department in 1995-1997 were submitted to a retrospective study. RESULTS We find only 27 cases (18. 8%) whose malignant changes were localized in the layers of mucosa.mucosalmuscle and submucosa,72 cases (50. 0 % , whose malignant changes had penetrated to the layer of serosa, and 43 cases (30. 7 % ) had lymph nodes metastases,18 cases (12. 5%) had blood metastases or implantations. We also find 51 cases (35. 5%) that couldn't get a definite diagnoses of malignant changes although 1-3 times of biopsies had been made before operation. and of them in fact 39 cases (74. 3%)had malignant changes that had penetrated to the layers muscle and serosa ,10 cases (19.6%) had metastases of lymph nodes and 7 cases (13. 7%) and blood metastases or implantations. CONCLUSION The adenoma with malignant change can not be considered as the early stage of carcinoma. We can not say the adenoma whose diagnosis was made by 1 - 3 times of biopsies is a real adenoma and certainly has no malignant change. We can not say the tumor whose original diagnosis was adenoma still belongs to the early stage of carcinoma either. So we suggest to treat the adenoma with malignant change correctly,aviod performing simple operation unreasonably.