Published online Jun 15, 2023. doi: 10.4251/wjgo.v15.i6.1062
Peer-review started: January 13, 2023
First decision: February 9, 2023
Revised: February 23, 2023
Accepted: April 23, 2023
Article in press: April 23, 2023
Published online: June 15, 2023
Processing time: 152 Days and 15.5 Hours
Currently, endoscopists frequently decide the treatment of colorectal polyps according to the characteristics of white light endoscopy, and polyps smaller than 2 cm usually do not receive adequate attention, leading to their inappropriate treatment.
Chicken skin mucosa (CSM) surrounding colon polyps is a common endoscopic finding that could be an endoscopic predictive marker of submucosal invasion. Therefore, we should consider the lesions with such characteristics and adopt more appropriate treatment.
To explore potential markers of small colorectal cancer early invasion under white light endoscopy, We found that CSM was more common in early submucosal invasive carcinoma than intramucosal carcinoma. Therefore, a more aggressive treatment should be used rather than cold-snare polypectomy or cold-snare endoscopic mucosal resection.
This retrospective cross-sectional study included 198 consecutive patients [233 early colorectal cancers (ECCs)] who underwent endoscopy or surgical procedures. Logistic regression analysis was used to examine the relationship between morphological characteristics, size, CSM prevalence, and invasion depth of ECC under white light endoscopy.
CSM, a depressed area with clear boundaries, erosion, or ulcer bleeding, and size (≥ 10 mm) were independent risk factors for submucosal invasion in ECC. We should consider the lesions with such characteristics and adopt more appropriate treatment.
CSM has a clinicopathological value for predicting deep immersion in early colorectal carcinoma in the left colon.
We will further expand our research to test our conclusions from various geographic, ethnic, and other factors.