Abstract
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.
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References
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.
Riddell RH. Premalignant and early malignant lesions in the gastrointestinal tract: definitions, terminology, and problems. Am J Gastroenterol 1996;91:864–72.
Fenoglio CM, Kaye GI, Lane N. Distribution of human colonic lymphatics in normal, hyperplastic, and adenomatous tissue. Gastroenterology 1973;64:51–66.
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.
Okuno M, Ikehara T, Nagayama M,et al. Clinicopathological study of early colorectal carcinoma. Nippon Daicho Komonbyo Gakkai Zasshi 1990;43:572–6.
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.
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.
Nagasako K, Sato S, Sugiyama S. The depth of invasion of colo-rectal tumors from endoscopic viewpoints. Stomach Intest (Tokyo) 1993;28:1169–82.
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.
Hewitt RE, Powe DG, Carter GI, Turner DR. Desmoplasia and its relevance to colorectal tumor invasion. Int J Cancer 1993;53:62–9.
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.
Kudo S. Endoscopic mucosal resection of flat and depressed types of early colorectal cancer. Endoscopy 1993;25:455–61.
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.
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.
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.
Watanabe M, Hirano T, Asano G. Roles of myofiboroblasts in the stroma of human gastric carcinoma. Nippon Geka Gakkai Zasshi 1995;96:10–8.
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.
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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
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DOI: https://doi.org/10.1007/BF02235375