Skip to main content

Advertisement

SpringerLink
Log in

Evaluation of new subclassification of type VI pit pattern for determining the depth and type of invasion of colorectal neoplasm

  • Original Article—Alimentary Tract
  • Published:
Journal of Gastroenterology Aims and scope Submit manuscript

Abstract

Background

Colorectal neoplasms with a type VI pit pattern include various lesions, such as adenomas, intramucosal cancers, and submucosal carcinomas.

Methods

We analyzed 96 colorectal neoplasms with a type VI pit pattern and identified six different variants: (1) unclear outline of the pit; (2) irregular margins of the pit; (3) narrowing of the pit; (4) ragged array of the pit; (5) high residual density of the pit; (6) abnormal branching of the pit. We examined the relationship between the appearance of each VI pit pattern and histology, including the depth of invasion.

Results

In univariate logistic regression analysis the unclear outline, irregular margins, and narrowing of the pit were significantly associated with a submucosal (SM) invasion ≥1000 μm (P < 0.01). In multivariate logistic regression analysis, unclear outline of the pit was shown to be the only significant predictor of highly invasive submucosal cancer (odds ratio = 24.20, P < 0.0001). Regarding tumor morphology, the following were significantly associated with an SM invasion ≥1000 μm: in protruded type, ragged array (P = 0.022), irregular margins of the pit (P = 0.011), and unclear outline of the pit (P < 0.01); in flat type, irregular margins of the pit (P < 0.01) and unclear outline of the pit (P < 0.01); and in the depressed type, narrowing of the pit (P = 0.015) and unclear outline of the pit (P < 0.01).

Conclusions

Subclassification of the type VI pit pattern is useful for determining the depth of invasion of colorectal neoplasms.

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

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Kudo S, Tamegai Y, Yamano H, Imai Y, Kogure E, Kashida H. Endoscopic mucosal resection of the colon: the Japanese technique. Gastrointest Endosc Clin N Am. 2001;11:519–35.

    CAS  PubMed  Google Scholar 

  2. Hurlstone DP, Fujii T, Lobo AJ. Early detection of colorectal cancer using high-magnification chromoscopic colonoscopy. Br J Surg. 2002;89:272–82.

    Article  CAS  PubMed  Google Scholar 

  3. Tanaka S, Kaltenbach T, Chayama K, Soetikno R. High magnification colonoscopy (with videos). Gastrointest Endosc. 2006;64:604–13.

    Article  PubMed  Google Scholar 

  4. Yamamoto S, Watanabe M, Hasegawa H, Baba H, Yoshinare K, Shiraishi J, Kitajima M. The risk of lymph node metastasis in T1 colorectal carcinoma. Hepatogastroenterology. 2004;51:998–1000.

    PubMed  Google Scholar 

  5. Kitajima K, Fujimori T, Fujii S, Takeda J, Ohkura Y, Kawamata H, Kumamoto T, Ishiguro S, Kato Y, Shimoda T, Iwashita A, Ajioka Y, Watanabe H, Watanabe T, Muto T, Nagasako K. Correlations between lymph node metastasis and depth of submucosal invasion in submucosal invasive colorectal carcinoma: a Japanese collaborative study. J Gastroenterol. 2004;39:534–43.

    Article  PubMed  Google Scholar 

  6. Oka S, Tanaka S, Kaneko I, Mouri R, Chayama K. Diagnosis of the invasion depth using magnifying videocolonoscopy in early colorectal carcinoma. Early Colorectal Cancer. 2005;9:161–8 (in Japanese with English abstract).

    Google Scholar 

  7. Ueno H, Mochizuki H, Hashiguchi Y, Shimazaki H, Aida S, Hase K, et al. Risk factors for an adverse outcome in early invasive colorectal carcinoma. Gastroenterology. 2004;127:385–94.

    Article  PubMed  Google Scholar 

  8. Coverlizza S, Risio M, Ferrari A, Fenoglio-Preiser CM, Rossini FP. Colorectal adenomas containing invasive carcinoma. Pathologic assessment of lymph node metastatic potential. Cancer. 1989;64:1937–47.

    Article  CAS  PubMed  Google Scholar 

  9. Minamoto T, Mai M, Ogino T, Sawaguchi K, Ohta T, Fujimoto T, et al. Early invasive colorectal carcinomas metastatic to lymph node with attention to their nonpolypoid development. Am J Gastroenterol. 1993;88:1035–9.

    CAS  PubMed  Google Scholar 

  10. Tsuruta O, Toyonaga A, Ikeda H, Tanikawa K, Morimatsu M. Clinicopathological study of superficial-type invasive carcinoma of the colorectum: special reference to lymph node metastasis. Int J Oncol. 1997;10:1003–8.

    Google Scholar 

  11. Sakuragi M, Togashi K, Konishi F, Koinuma K, Kawamura Y, Okada M, et al. Predictive factors for lymph node metastasis in T1 stage colorectal carcinomas. Dis Colon Rectum. 2003;46:1626–32.

    Article  PubMed  Google Scholar 

  12. Tamura S, Yokoyama Y, Ookawauchi K, Onishi T, Onishi S, Miyazaki J. Evaluation of the type V pit pattern in the lesions of colonic Tis and T1 cancer. Dig Endosc. 2003;15:185–9.

    Article  Google Scholar 

  13. Kudo S, Hirota S, Nakajima T, Hosobe S, Kusaka H, Kobayashi T, et al. Colorectal tumours and pit pattern. J Clin Pathol. 1994;47:880–5.

    Article  CAS  PubMed  Google Scholar 

  14. Kudo S, Tamura S, Nakajima T, Yamano H, Kusaka H, Watanabe H. Diagnosis of colorectal tumorous lesions by magnifying endoscopy. Gastrointest Endosc. 1996;44:8–14.

    Article  CAS  PubMed  Google Scholar 

  15. Togashi K, Konishi F, Ishizuka T, Sato T, Senba S, Kanazawa K. Efficacy of magnifying endoscopy in the differential diagnosis of neoplastic and non-neoplastic polyps of the large bowel. Dis Colon Rectum. 1999;42:1602–8.

    Article  CAS  PubMed  Google Scholar 

  16. Kato S, Fujii T, Koba I, Sano Y, Fu KI, Parra-Blanco A, et al. Assessment of colorectal lesions using magnifying colonoscopy and mucosal dye spraying: can significant lesions be distinguished? Endoscopy. 2001;33:306–10.

    Article  CAS  PubMed  Google Scholar 

  17. Tsuji Y. Usefulness of magnifying endoscopy for diagnosing tumorous lesions of the colorectum. Kurume Med J. 1998;45:87–94.

    CAS  PubMed  Google Scholar 

  18. Tanaka S, Haruma K, Hirota Y, et al. Pit pattern diagnosis using magnifying colonoscope for colorectal tumor with special reference to the comparison with ordinary colonoscopic observation. Early Colorectal Cancer. 1999;3:147–55 (in Japanese with English abstract).

    Google Scholar 

  19. Tanaka S, Haruma K, Nagata S, Oka S, Chayama K. Diagnosis of invasion depth in early colorectal carcinoma by pit pattern analysis with magnifying endoscopy. Dig Endosc. 2001;13S:S2–5.

    Article  Google Scholar 

  20. Tanaka S, Haruma K, Ito M, Nagata S, Oh-e H, Hirota Y, et al. Detailed colonoscopy for detecting early superficial carcinoma: recent developments. J Gastroenterol. 2000;35:121–5.

    Article  PubMed  Google Scholar 

  21. Tamura S, Yokoyama Y, Tadokoro T, Higashidani Y, Onishi S. Pit pattern and pathological diagnosis in the patients with colorectal tumors. Dig Endosc. 2001;13(Suppl):6–7.

    Article  Google Scholar 

  22. Kudo S, Rubio CA, Teixeira CR, Kashida H, Kogure E. Pit pattern in colorectal neoplasia: endoscopic magnifying view. Endoscopy. 2001;33:367–73.

    CAS  PubMed  Google Scholar 

  23. Kawano H, Tsuruta O, Ikeda H, Toyonaga A, Tanikawa K. Diagnosis of the level of depth in superficial depressed-type colorectal tumors in terms of stereomicroscopic pit patterns. Int J Oncol. 1998;12:769–75.

    CAS  PubMed  Google Scholar 

  24. Onishi T, Tamura S, Kuratani Y, Onishi S, Yasuda N. Evaluation of the depth score of type V pit patterns in crypt orifices of colorectal neoplastic lesions. J Gastroenterol. 2008;43:291–7.

    Article  PubMed  Google Scholar 

  25. Kanao H, Tanaka S, Oka S, Kaneko I, Yoshida S, Arihiro K, et al. Clinical significance of type VI pit pattern subclassification in determining the depth of invasion of colorectal neoplasms. World J Gastroenterol. 2008;14(2):211–7.

    Article  PubMed  Google Scholar 

  26. Hamilton SR, Aaltonen LA, editors. World Health Organization classification of tumours: pathology and genetics of tumours of the digestive system. Lyon. France: IARC; 2000. p. 104–19.

    Google Scholar 

  27. Tanaka S, Haruma K, Oh-e H, Nagata S, Hirota Y, Furudoi A, et al. Conditions of curability after endoscopic resection for colorectal carcinoma with submucosally massive invasion. Oncol Rep. 2000;7:783–8.

    CAS  PubMed  Google Scholar 

  28. Hamatani S, Hisayuki T. Histopathological analysis for typeVI pit patterns. Early Colorectal Cancer. 1999;3:147–55 (in Japanese with English abstract).

    Google Scholar 

  29. Tobaru T, Tsuruta O, Kawano H, Sawa Y, Sata M. Clinical efficacy of VI pit pattern subclassification employing magnifying endoscopy in diagnosis of early colorectal cancer invasion depth. Early Colorectal Cancer. 2007;5:403–8 (in Japanese with English abstract).

    Google Scholar 

  30. Tobaru T, Tsuruta O, Kawano H, Yoshimori K, Sata M. The relationship between the subclassification of type VI pit patterns and superficial histological constructions in early colorectal cancer. Early Colorectal Cancer. 2006;3:207–14 (in Japanese with English abstract).

    Google Scholar 

  31. Tobaru T, Tsuruta O, Kawano H, Yoshimori K, Toyonaga A. Efficacy of subclassified type VI pit pattern using magnifying endoscopy in diagnosis of invasion depth of early colorectal cancer. Early Colorectal Cancer. 2005;2:151–9 (in Japanese with English abstract).

    Google Scholar 

  32. Tsuji Y, Tsuruta O, Kawano H, Tobaru T, Tomiyasu N, Nakahara K, et al. Effectiveness of magnifying endoscopy in diagnosing the invasion depth of pedunculated and semi-pedunculated colorectal cancer. Stomach Intestine. 2002;12:1571–81 (in Japanese with English abstract).

    Google Scholar 

  33. Ajioka Y, Tsuruta O, Hayashi T, Fujii T. Case conference. Early Colorectal Cancer. 2007;5:434–51.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Gastroenterology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan

    Kenshi Matsumoto, Akihito Nagahara, Takeshi Terai, Hiroya Ueyama, Hideaki Ritsuno, Hiroki Mori, Kohsaburo Nakae, Kazuko Beppu, Tomoyoshi Shibuya, Naoto Sakamoto, Taro Osada, Tatsuo Ogihara & Sumio Watanabe

  2. Department of Human Pathology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan

    Takashi Yao

Authors
  1. Kenshi Matsumoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Akihito Nagahara
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Takeshi Terai
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hiroya Ueyama
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hideaki Ritsuno
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Hiroki Mori
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Kohsaburo Nakae
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Kazuko Beppu
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Tomoyoshi Shibuya
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Naoto Sakamoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Taro Osada
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Tatsuo Ogihara
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Takashi Yao
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Sumio Watanabe
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kenshi Matsumoto.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Matsumoto, K., Nagahara, A., Terai, T. et al. Evaluation of new subclassification of type VI pit pattern for determining the depth and type of invasion of colorectal neoplasm. J Gastroenterol 46, 31–38 (2011). https://doi.org/10.1007/s00535-010-0300-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00535-010-0300-y

Keywords

Search

Navigation