Endoscopic and pathological characteristics of de novo colorectal cancer: Retrospective cohort study

doi:10.3748/wjg.v29.i18.2836

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World Journal of Gastroenterology

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Retrospective Cohort Study

World J Gastroenterol. May 14, 2023; 29(18): 2836-2849
Published online May 14, 2023. doi: 10.3748/wjg.v29.i18.2836

Table 1 The clinical information of de novo and carcinoma in adenoma colorectal cancers

		De novo (n = 33)	CIA (n = 30)	χ²	P value
Clinical information
Age (%)	> 55	30 (90.9)	25 (83.3)	0.814	> 0.05
	< 55	3 (9.1)	5 (16.7)
Gender (%)	Male	16 (48.5)	16 (53.3)	0.148	> 0.05
	Female	17 (51.5)	14 (46.7)
Smoking history (%)	Yes	27 (81.8)	19 (63.3)	2.725	> 0.05
	No	6 (18.2)	11 (36.7)
Location (%)	Proximal	7 (21.2)	21 (70.0)	15.149	< 0.05
	Distal	26 (78.8)	9 (30.0)
Depth of invasion	M	8 (24.2)	9 (30.0)	1.504	> 0.05
	SMp	9 (27.3)	11 (36.7)
	SMd	16 (48.5)	10 (33.3)
Treatment (%)	Surgery	21 (63.6)	16 (53.3)	0.688	> 0.05
	Endoscopy	12 (36.4)	14 (46.7)
Supplement chemotherapy (%)	Yes	21 (63.6)	12 (40.0)	3.520	> 0.05
	No	12 (36.4)	18 (60.0)
Distal metastasis (%)	Yes	5 (15.2)	2 (6.7)	1.145	> 0.05
	No	28 (84.8)	28 (93.3)
Overall survival (%)	1 yr	33 (100.0)	30 (100.0)
	3 yr	30 (90.9)	28 (93.3)
	5 yr	23 (69.7)	28 (93.3)
DSS	Yes	26 (78.8)	28 (93.3)	2.715	> 0.05
	No	7 (21.2)	2 (6.7)
Endoscopic gross characteristics
Size%	1 cm < S ≤ 2 cm	14 (42.4)	9 (30.0)	30.514	< 0.05
	≤ 1 cm	16 (48.5)	0 (0.0)
	> 2 cm	3 (9.1)	21 (70.0)
Macroscopic type%	Is	5 (15.2)	6 (20.0)	35.187	< 0.05
	IIa + IIc	11 (33.3)	1 (3.3)
	IIc	17 (51.5)	4 (13.3)
	Is + IIc	0 (0.0)	19 (63.3)
Surface change	Erosion	24 (72.7)	13 (43.3)	9.457	< 0.05
	Ulceration	2 (6.1)	11 (36.7)
	None	7 (21.2)	6 (20.0)
Color change	Reddened mucosa	26 (78.8)	2 (6.7)	33.104	< 0.05
	None	7 (21.2)	28 (93.3)
NICE	Type 1	0 (0.0)	0 (0.0)		> 0.05
	Type 2	0 (0.0)	0 (0.0)
	Type 3	33 (100.0)	30 (100.0)
Sano	I	0 (0.0)	0 (0.0)	5.292	< 0.05
	II	0 (0.0)	0 (0.0)
	IIIA	17 (51.5)	7 (23.3)
	IIIB	16 (48.5)	23 (76.7)
JNET	1	0 (0.0)	0 (0.0)	3.094	> 0.05
	2A	0 (0.0)	0 (0.0)
	2B	12 (36.4)	5 (16.7)
	3	21 (63.6)	25 (83.3)
Chemical staining (crystal violet)
Pit pattern	Vi	1 (3.0)	6 (20.0)	15.774	< 0.05
	Vn	13 (39.4)	15 (50.0)
	Vi + Vn	19 (57.6)	5 (16.7)
	IV + Vi	0 (0.0)	4 (13.3)
Pit pattern at the edge of the tumors	I	33 (100.0)	0 (0.0)	63.000	< 0.05
	III + VI	0 (0.0)	30 (100.0)
Surrounding mucosa
Pulling	Yes	9 (27.3)	21 (70.0)	11.501	< 0.05
	No	24 (72.7)	9 (30.0)
Converging folds	Yes	27 (81.8)	15 (50.0)	7.159	< 0.05
	No	6 (18.2)	15 (50.0)
CSM	CSM1	11 (33.3)	4 (13.3)	3.553	> 0.05
	CSM2	17 (51.5)	21 (70.0)
	CSM3	5 (15.2)	5 (16.7)

CRC: Colorectal cancer; DSS: Disease specific survival; CSM: Chicken skin mucosa; CIA: Carcinoma in adenoma; NICE: Narrow-band imaging International Colorectal Endoscopic.

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Table 2 The endoscopic characteristics in de novo and carcinoma in adenoma groups

		De novo (n = 22)	CIA (n = 20)	χ²	P value
Budding	BD1	8 (24.2)	4 (13.3)	6.161	> 0.05
	BD2	8 (24.2)	6 (20.0)
	BD3	11 (33.3)	6 (20.0)
	None	5 (18.2)	14 (46.7)
Grading	G1	6 (18.2)	13 (43.3)	8.878	> 0.05
	G2	11 (33.3)	9 (30.0)
	G1-2	10 (30.3)	8 (26.7)
	G3-2	6 (18.2)	0 (0.0)
TIL	Yes	27 (81.8)	19 (63.3)	2.725	> 0.05
	No	6 (18.2)	11 (36.7)
Perineural infiltration	Yes	16 (48.5)	3 (10.0)	11.050	< 0.05
	No	17 (51.5)	27 (90.0)
Lymphovascular invasion	Yes	16 (48.5)	7 (23.3)	4.289	< 0.05
	No	17 (51.5)	23 (76.7)
Growth pattern	INFa	0 (0.0)	27 (90.0)	63.000	< 0.05
	INFb	0 (0.0)	3 (10.0)
	INFc	33 (100.0)	0 (0.0)
Lymph node metastasis	Yes	10 (30.3)	1 (3.3)	7.931	> 0.05
	No	23 (69.7)	29 (96.7)
Adjacent lesions	Inflammation	33 (100.0)	0 (0.0)	63.000	< 0.05
	Adenoma	0 (0.0)	17 (56.7)
	Hyperplasia	0 (0.0)	13 (43.3)
IHC-E-cadherin	No staining	0 (0.0)	0 (0.0)	22.609	< 0.05
	Weak	17 (51.5)	2 (6.7)
	Moderate	15 (48.5)	19 (63.3)
	Strong	0 (0.0)	9 (30.0)
IHC-Vimentin	No staining	0 (0.0)	0 (0.0)	23.182	< 0.05
	Weak	13 (39.4)	18 (60.0)
	Moderate	1 (3.0)	10 (33.3)
	Strong	19 (57.6)	2 (6.7)

CIA: Carcinoma in adenoma; TIL: Tumor Infiltrating Lymphocyte; IHC: Immunohistochemistry; BD: Budding grade.

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Table 3 The risk factors are related to the depth of invasion

Depth of invasion	M	SM-S	SM-d and deeper	r	P value
Size, %				-0.002	> 0.05
1 cm < S ≤ 2 cm	1 (12.5)	0 (0.0)	13 (81.3)
≤ 1 cm	7 (87.5)	9 (100.0)	0 (0.0)
> 2 cm	0 (0.0)	0 (0.0)	3 (18.8)
Growth pattern					> 0.05
IFNa	0 (0.0)	0 (0.0)	0 (0.0)
IFNb	0 (0.0)	0 (0.0)	0 (0.0)
IFNc	8 (100.0)	9 (100.0)	16 (100.0)
Differential degree				0.904	< 0.001
G1	5 (62.5)	1 (11.1)	0 (0.0)
G2	3 (37.5)	8 (88.9)	0 (0.0)
G1-2	0 (0.0)	0 (0.0)	10 (62.5)
G3-2	0 (0.0)	0 (0.0)	6 (37.5)
Macroscopic type				-0.093	> 0.05
Is	2 (25.0)	0 (0.0)	13 (81.3)
IIa + IIc	6 (75.0)	9 (100.0)	0 (0.0)
IIc	0 (0.0)	0 (0.0)	3 (18.8)
Is + IIc	0 (0.0)	0 (0.0)	0 (0.0)
NICE					> 0.05
Type 1	0 (0.0)	0 (0.0)	0 (0.0)
Type 2	0 (0.0)	0 (0.0)	0 (0.0)
Type 3	8 (100.0)	9 (100.0)	16 (100.0)
Sano				0.938	< 0.001
I	0 (0.0)	0 (0.0)	0 (0.0)
II	0 (0.0)	0 (0.0)	0 (0.0)
IIIA	8 (100.0)	9 (100.0)	0 (0.0)
IIIB	0 (0.0)	0 (0.0)	16 (100.0)
JNET				0.649	< 0.001
1	0 (0.0)	0 (0.0)	0 (0.0)
2A	0 (0.0)	0 (0.0)	0 (0.0)
2B	5 (62.5)	7 (77.8)	0 (0.0)
3	3 (37.5)	2 (22.2)	16 (100.0)
Pit pattern				-0.491	< 0.001
Vi	1 (12.5)	0 (0.0)	0 (0.0)
Vn	0 (0.0)	0 (0.0)	13 (81.3)
Vi + Vn	7 (87.5)	9 (100.0)	3 (18.8)
IV + Vi	0 (0.0)	0 (0.0)	0 (0.0)
Pit pattern at the edge of the tumors					> 0.05
I	8 (100.0)	9 (100.0)	16 (100.0)
III + VI	0 (0.0)	0 (0.0)	0 (0.0)
Surrounding mucosa
Pulling				-0.567	< 0.001
Yes	0 (0.0)	0 (0.0)	9 (56.3)
No	8 (100.0)	9 (100.0)	7 (43.8)
Converging folds				-0.62	< 0.001
Yes	3 (37.5)	8 (88.9)	16 (100.0)
No	5 (62.5)	1 (11.1)	0 (0.0)
CSM				-0.796	< 0.001
CSM1	0 (0.0)	0 (0.0)	11 (68.8)
CSM2	3 (37.5)	9 (100.0)	5 (31.3)
CSM3	5 (62.5)	0 (0.0)	0 (0.0)

IFN: Infiltration; CSM: Chicken skin mucosa; NICE: Narrow-band imaging International Colorectal Endoscopic.

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Table 4 The risk factors are related to tumor budding

	BD1	BD2	BD3	No budding	r	P value
Infiltrative depth, %					0.669	< 0.001
M	0 (0.0)	3 (21.4)	0 (0.0)	14 (70.0)
SMp	10 (83.3)	1 (7.1)	3 (17.6)
SMd	2 (16.7)	10 (71.4)	14 (82.4)
Lymphovascular invasion					0.663	< 0.001
Yes	2 (28.6)	4 (21.1)	16 (94.1)	1 (5.0)
No	5 (71.4)	15 (78.9)	1 (5.9)	19 (95.0)
Lymph node metastasis					0.489	< -0.001
Yes	1 (14.3)	1 (5.3)	9 (52.9)	0 (0.0)
No	6 (85.7)	18 (94.7)	8 (41.7)	20 (100.0)
Perineural infiltration					0.601	< 0.001
Yes	2 (28.6)	4 (21.1)	13 (76.5)	0 (0.0)
No	5 (71.4)	15 (78.9)	4 (23.5)	20 (100.0)
Tumor infiltrating lymphocytes					0.476	< 0.001
Yes	7 (100.0)	19 (100.0)	14 (82.4)	6 (30.0)
No	0 (0.0)	0 (0.0)	3 (17.6)	14 (70.0)
Differential degree					0.706	< 0.001
G1	0 (0.0)	0 (0.0)	0 (0.0)	19 (95.0)
G1-2	2 (28.6)	9 (47.4)	7 (41.2)	0 (0.0)
G2	5 (71.4)	10 (52.6)	4 (23.5)	1 (5.0)
G3-2	0 (0.0)	0 (0.0)	6 (35.3)	0 (0.0)

BD: Budding grade.

Full Size Table

Citation: Li SY, Yang MQ, Liu YM, Sun MJ, Zhang HJ. Endoscopic and pathological characteristics of de novo colorectal cancer: Retrospective cohort study. World J Gastroenterol 2023; 29(18): 2836-2849
URL: https://www.wjgnet.com/1007-9327/full/v29/i18/2836.htm
DOI: https://dx.doi.org/10.3748/wjg.v29.i18.2836