Clinical significance of type VI pit pattern subclassification in determining the depth of invasion of colorectal neoplasms

doi:10.3748/wjg.14.211

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Jan 14, 2008 (publication date) through Nov 8, 2024

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Colorectal Cancer

World J Gastroenterol. Jan 14, 2008; 14(2): 211-217
Published online Jan 14, 2008. doi: 10.3748/wjg.14.211

Clinical significance of type V_I pit pattern subclassification in determining the depth of invasion of colorectal neoplasms

Hiroyuki Kanao, Shinji Tanaka, Shiro Oka, Iwao Kaneko, Shigeto Yoshida, Koji Arihiro, Masaharu Yoshihara, Kazuaki Chayama

Hiroyuki Kanao, Iwao Kaneko, Kazuaki Chayama, Department of Medicine and Molecular Science, Hiroshima University Graduate School of Biomedical Science, Hiroshima, Japan

Shinji Tanaka, Shiro Oka, Shigeto Yoshida, Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan

Koji Arihiro, Department of Pathology, Hiroshima University Hospital, Hiroshima, Japan

Masaharu Yoshihara, Health Service Center, Hiroshima University, Hiroshima, Japan

Correspondence to: Shinji Tanaka, MD, PhD, Department of Endoscopy, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan. colon@hiroshima-u.ac.jp

Telephone: +81-82-2575538

Fax: +81-82-2575538

Received: August 20, 2007
Revised: September 29, 2007
Published online: January 14, 2008

Abstract

AIM: To clarify whether subclassification of the type V_I pit pattern on the basis of magnifying colonoscopy findings is useful in determining the type and depth of invasion of colorectal neoplasms.

METHODS: We retrospectively analyzed 272 colorectal neoplasms (117 dysplasias and 155 submucosal invasive carcinomas; 228 patients) with a type V pit pattern [type V_I, n = 202; type V_N, n = 70 (Kudo and Tsuruta classification system)]. We divided lesions with a type V_I pit pattern into two subclasses, mildly irregular lesions and severely irregular lesions, according to the prominent and detailed magnifying colonoscopy findings. We examined the relation between these two subclasses and histology/invasion depth.

RESULTS: One hundred and four lesions (51.5%) were judged to be mildly irregular, and 98 lesions (48.5%) were judged to be severely irregular. Ninety-seven (93.3%) mildly irregular lesions showed dysplasias or submucosal invasion of less than 1000 &mgr;m (SM < 1000 &mgr;m). Fifty-five (56.1%) severely irregular lesions showed submucosal invasion equal to or deeper than 1000 &mgr;m (SM ≥ 1000 &mgr;m). Mild irregularity was found significantly more often in dysplasias or lesions with SM < 1000 &mgr;m than in lesions with SM ≥ 1000 &mgr;m (P < 0.01).

CONCLUSION: Subclassification of the type V_I pit pattern is useful for identifying dysplasias or lesions with SM < 1000 &mgr;m.

Keywords: Colorectal neoplasm; Magnification; Type V_I pit pattern; Depth of invasion