Springer Nature is making SARS-CoV-2 and COVID-19 research free. View research | View latest news | Sign up for updates

Desmoplastic response in biopsy specimens of early colorectal carcinoma is predictive of deep submucosal invasion

  • 27 Accesses

  • 8 Citations


PURPOSE: The aim of this study was to evaluate the role of histopathology of biopsy specimens in predicting depth of infiltration in early colorectal carcinomas before treatment. METHODS: Early colorectal carcinomas that had been resected surgically or endoscopically between 1984 and 1995 were analyzed. Histopathologic findings, including differentiation of adenocarcinoma and a desmoplastic response were investigated. RESULTS: One hundred nine early colorectal carcinomas consisted of 73 lesions of carcinomain situ, 13 submucosal carcinomas with minimum invasion, 8 lesions with moderate invasion, and 15 lesions with deep invasion. Of 73 carcinomain situ lesions, 72 (approximately 99 percent) showed well-differentiated adenocarcinomas and no desmoplastic response. Twelve (92 percent) of 13 submucosal carcinomas with minimum invasion also revealed well-differentiated adenocarcinoma without a desmoplastic response. Sixty-three percent (5/8)of lesions with moderate invasion revealed well-differentiated adenocarcinoma. None of the lesions had a desmoplastic response. Among lesions with deep invasion, 73 percent (11/15) demonstrated moderately differentiated adenocarcinoma, and 11 lesions had a prominent desmoplastic response (73 percent;P<0.01). CONCLUSIONS: These results suggest that if histopathologic findings of biopsy specimens taken from them before treatment demonstrated adenocarcinoma associated with a desmoplastic response, the lesions had at least deep invasion carcinomas. These lesions should be resected surgically. Submucosal carcinomas with minimum invasion, which have no desmoplastic response, could be treated endoscopically.

This is a preview of subscription content, log in to check access.


  1. 1.

    Japanese Research Society for Cancer of the Colon and Rectum. General rules for clinical and pathological studies on cancer of the colon, rectum and anus. 5th ed. Tokyo: Kanahara, 1994.

  2. 2.

    Riddell RH. Premalignant and early malignant lesions in the gastrointestinal tract: definitions, terminology, and problems. Am J Gastroenterol 1996;91:864–72.

  3. 3.

    Fenoglio CM, Kaye GI, Lane N. Distribution of human colonic lymphatics in normal, hyperplastic, and adenomatous tissue. Gastroenterology 1973;64:51–66.

  4. 4.

    Tanaka S, Yokota T, Saito D, Okamoto S, Oguro Y, Yoshida S. Clinicopathologic features of early rectal carcinoma and indications for endoscopic treatment. Dis Colon Rectum 1995;38:959–63.

  5. 5.

    Okuno M, Ikehara T, Nagayama M,et al. Clinicopathological study of early colorectal carcinoma. Nippon Daicho Komonbyo Gakkai Zasshi 1990;43:572–6.

  6. 6.

    Oohara N, Nagasako K, Baba R,et al. A study on the lymph-node metastasis and the prognosis in patients of colorectal sm cancer. Nippon Daicho Komonbyo Gakkai Zasshi 1991;44:952–6.

  7. 7.

    Ushio K, Ishikawa T, Miyakawa K,et al. Diagnosis of the depth of invasion of colonic cancer, a supplement to the theory of the radiological diagnosis and notes for reading images. Stomach Intest (Tokyo) 1993;28:1141–55.

  8. 8.

    Nagasako K, Sato S, Sugiyama S. The depth of invasion of colo-rectal tumors from endoscopic viewpoints. Stomach Intest (Tokyo) 1993;28:1169–82.

  9. 9.

    Shimizu S, Tada S, Otsuka H,et al. Evaluation of the depth of colorectal cancers using endoscopic ultrasonography in comparison with barium enema and colonoscopic examinations. Stomach Intest (Tokyo) 1993;28:1183–9.

  10. 10.

    Hewitt RE, Powe DG, Carter GI, Turner DR. Desmoplasia and its relevance to colorectal tumor invasion. Int J Cancer 1993;53:62–9.

  11. 11.

    Lienbeau B, Garrigue L, Barbieux I, Meflah K, Gregoire, M. The role of transforming growth factor beta 1 in the fibroblastic reaction associated with rat colorectal tumor development. Cancer Res 1994;54:6526–32.

  12. 12.

    Kudo S. Endoscopic mucosal resection of flat and depressed types of early colorectal cancer. Endoscopy 1993;25:455–61.

  13. 13.

    Haggitt RC, Glotzbach RE, Soffer EE, Wruble LD. Prognostic factors in colorectal carcinomas arising in adenomas: implications for lesions removed by endoscopic polypectomy. Gastroenterology 1985;89:328–36.

  14. 14.

    Nivatvongs S, Rojanasakul A, Reiman HM,et al. The risk of lymph node metastasis in colorectal polyps with invasive adenocarcinoma. Dis Colon Rectum 1991;34:323–8.

  15. 15.

    Miura S, Kodaira S, Hosoda Y. Immunohistologic analysis of the extracellular matrix components of the fibrous stroma of human colon cancer. J Surg Oncol 1993;53:36–42.

  16. 16.

    Watanabe M, Hirano T, Asano G. Roles of myofiboroblasts in the stroma of human gastric carcinoma. Nippon Geka Gakkai Zasshi 1995;96:10–8.

  17. 17.

    Barsky SH, Gopalakrishna R. Increased invasion and spontaneous metastasis of BL6 melanoma with inhibition of the desmoplastic response in C57 BL/6 mice. Cancer Res 1987;47:1663–7.

Download references

Author information

Correspondence to Dr. Ichiro Nakada M.D..

About this article

Cite this article

Nakada, I., Tasaki, T., Ubukata, H. et al. Desmoplastic response in biopsy specimens of early colorectal carcinoma is predictive of deep submucosal invasion. Dis Colon Rectum 41, 896–900 (1998). https://doi.org/10.1007/BF02235375

Download citation

Key words

  • Early colorectal carcinoma
  • Depth of invasion
  • Desmoplastic response