Conventional endoscopic features are not sufficient to differentiate small, early colorectal cancer

Table 1 Baseline characteristics and endoscopic findings according to the depth of invasion in submucosal cancer n (%)

	Deep submucosal cancer (n = 25)	Superficial submucosal cancer (n = 39)	P value
Age (mean ± SD, yr)	58.4 ± 8.5	62.4 ± 9.8	0.097
Sex			0.241
Male	13 (52.0)	26 (66.7)
Female	12 (48.0)	13 (33.3)
Size (mm)	16.88 ± 3.28	15.28 ± 3.64	0.080
Shape
Sessile	8 (32.0)	18 (46.2)	0.397
Pedunculated	5 (20.0)	4 (10.3)
Superfical (Flat)	12 (48.0)	17 (43.6)
Location			0.581
Right colon	8 (32.0)	10 (25.6)
Left colon	17 (68.0)	29 (74.4)
Endoscopic finding
Morphological features
Any of them	22 (88.0)	27 (69.2)	0.084
None of them	3 (12.0)	12 (30.8)
(P, S) Loss of lobulation	3/13 (23.1)	7/22 (31.8)	0.709
(P, S) Excavation	0/13 (0.0)	1/22 (4.5)	1.000
(All) Demarcated depressed area	13/25 (52.0)	17/39 (43.6)	0.511
(P) Stalk swelling	5/5 (100.0)	2/4 (50.0)	0.167
(F) Fullness	3/12 (25.0)	0/17 (0.0)	0.060
(F) Fold convergency	1/12 (8.3)	0/17 (0.0)	0.414
(All) Ulcer bleeding	1/25 (4.0)	1/39 (2.6)	1.000
Pit pattern			1.000
Non-invasive	1 (4.0)	2 (5.1)
Invasive	24 (96.0)	37 (94.9)
Non-lifting sign			0.010
Positive	17 (85.0)	17 (48.6)
Negative	3 (15.0)	18 (51.4)

Superficial tumors: Superficial submucosal cancer and adenoma; P: Pedunculated type; S: Sessile type; F: Flat/depressed type.

Table 2 Baseline characteristics and endoscopic findings according to the depth of invasion n (%)

	Deep submucosal cancer (n = 25)	Superficial tumors (n = 191)	P value
Age (mean ± SD, yr)	58.4 ± 8.5	61.0 ± 9.4	0.191
Sex			0.179
Male	13 (52.0)	128 (67.0)
Female	12 (48.0)	63 (33.0)
Size (mm)	16.88 ± 3.28	12.25 ± 4.93	< 0.001
Shape
Sessile	8 (32.0)	106 (55.5)	0.005
Pedunculated	5 (20.0)	48 (25.1)
Superfical (Flat)	12 (48.0)	37 (19.4)
Location			1.000
Right colon	8 (32.0)	57 (29.8)
Left colon	17 (68.0)	134 (70.2)
Endoscopic finding
Morphological features
Any of them	22 (88.0)	59 (30.9)	< 0.001
None of them	3 (12.0)	132 (69.1)
(P, S) Loss of lobulation	3/13 (23.1)	27/154 (17.5)	0.705
(P, S) Excavation	0/13 (0.0)	3/154 (1.9)	1.000
(All) Demarcated depressed area	13/25 (52.0)	30/191 (15.7)	< 0.001
(P) Stalk swelling	5/5 (100.0)	2/48 (4.2)	< 0.001
(F) Fullness	3/12 (25.0)	0/37 (0.0)	0.001
(F) Fold convergency	1/12 (8.3)	0/37 (0.0)	0.310
(All) Ulcer bleeding	1/24 (4.0)	2/189 (1.0)	0.245
Pit pattern			< 0.001
Non-invasive	1 (4.0)	154 (80.6)	< 0.001
Invasive	24 (96.0)	37 (19.4)
Non-lifting sign			< 0.001
Positive	17 (85.0)	22 (28.6)
Negative	3 (15.0)	55 (71.4)

Superficial tumors: Superficial submucosal cancer and adenoma; P: Pedunculated type; S: Sessile type; F: Flat/depressed type.

Table 3 Diagnostic accuracy of conventional endoscopic features

	Sensitivity	Specificity	PPV	NPV	Accuracy
Invasive morphology1	0.88	0.69	0.27	0.98	0.71
Invasive pit pattern1	0.96	0.81	0.39	0.99	0.82
Non-lifting sign2	0.85	0.73	0.46	0.95	0.75

¹Evaluated in all polyps;

²Evaluated in sessile and flat polyps. Deep submucosal cancer superficial tumors. PPV: Positive predictive value; NPV: Negative predictive value.