Abstract. We analyzed pit patterns of colorectal tumors with magnifying colonoscopy, focusing on the relationship between the V I pattern sub-classification and the depth of tumor invasion. The V I pattern was divided into the well-demarcated and poorly demarcated subtypes. The percentage of tumors with a depth of invasion of over 1,000 μm was in the order of non-V types (type I-IV) < type V I < type V N . Most welldemarcated V I lesions (80.8%) showed a depth of invasion of <1,000 μm compared to only 21.1% of poorly demarcated V I lesions. Both the frequency of degeneration or prolapse of the epithelial lining and the frequency of desmoplastic reaction occurred in the order of non-V types < type V I < type V N , while the degree of histological differentiation and the frequency of residual muscularis mucosae occurred in the order of non-V types > type V I > type V N . Furthermore, the poorly demarcated V I subtype showed a higher frequency of epithelial lining degeneration or prolapse and a lower frequency of residual muscularis mucosae than the welldemarcated V I subtype. Tumors with a depth of invasion of >1,000 μm showed a higher frequency of epithelial lining degeneration or prolapse, a lower degree of histological differentiation, a higher frequency of desmoplastic reaction, and a lower frequency of residual muscularis mucosae than did tumors with <1,000 μm of invasion. These results suggest that V I pit pattern sub-classification is a useful indicator of the depth of colorectal tumor invasion and treatment selection. A prospective study on this subject would be useful.

A case of alpha-fetoprotein (AFP) and des-gamma-carboxy prothrombin (DCP) producing gastric cancer with multiple liver metastasis is reported. The simultaneous presence of Borrmann I gastric cancer and IIa aggregating type gastric cancer was noted. Borrmann I gastric cancer was a poorly differentiated adenocarcinoma, while IIa aggregating type gastric cancer was a moderately differentiated adenocarcinoma. Plasma levels of AFP and DCP were 247,000 ng/ml and 320,000 mAU/ml, respectively. Immunohistochemical staining confirmed the production of these two proteins in Borrmann I gastric cancer.