Toshihide Iijima

Angiographic diagnosis of the degree of serosal invasion of carcinoma of the colon

Angiography using Prostaglandin El® was performed on 38 patients with carcinoma of the colon in order to diagnose the degree of serosal cancer invasion. The findings at angiography were classified into four groups:1) AG-S3, abnormal change (irregularity and/or encasement) up to marginal vessels; 2) AG-S2, abnormality up to vasa recta; 3) AG-S1, abnormality of penetrating branches of vasa recta within the wall of the colon; and 4) AG-S0, no distinct findings of abovementioned vessels. These angiographic findings were compared with both macroscopic and microscopic serosal cancer invasion. Angiographic diagnosis is in accord with the macroscopic findings in 84.2 percent of cases. Angiographic diagnosis is in accord with the microscopic findings in 32.4 percent of cases. Macroscopic findings confirm the angiographic diagnosis precisely but the conflict with microscopic findings should not be overlooked. This may be the result of inflammatory change, adhesion, and fibrosis around carcinoma of the colon.

Pharmacoangiographic diagnosis of venous invasion of carcinoma of the colon with reference to liver metastases

Angiography using prostaglandin E1 was performed on 34 patients with carcinoma of the colon in order to define the degree of venous invasion. Venous findings on angiogram (occlusion and/or encasement) were classified into three groups: AG-V2, above-mentioned venous findings up to marginal vein; AG-V1, these findings up to the vasa recta; AG-V0, no distinct findings on the vein. These venous findings were compared with histologic subserosal venous invasion that was diagnosed with both hematoxylin and eosin and elastica van Giesons staining. When angiographic findings were compared with histologic subserosal venous invasion, the results of AG-V2, AG-V1, and AG-V0 showed a positive correlation of 92.3 percent, 46.7 percent, and 16.7 percent, respectively. The angiographic findings were also correlated with the degree of fibrosis around the carcinoma of the colon. The incidence rate of liver metastasis in a group of AG-V2 was 46.2 percent. In AG-V1 it was 26.7 percent and in AG-V0 0 percent. In the course of the postoperative follow-up, liver metastases appeared in two cases of AG-V2 and AG-V1, respectively. This finding may suggest the presence of liver micrometastases at the time of surgery.