Predictors for malignant potential and deep submucosal invasion in colorectal laterally spreading tumors

Table 1 Characteristics of the patients and lesions

	Total
Number of patients	323
Male sex, n (%)	181 (56.0)
Age, mean ± SD, yr	64.7 ± 10.5
Number of lesions	341
Size, median (IQR), cm	2.0 (1.5-3.0)
Location, n (%)
Caecum and ascending colon	137 (40.2)
Transverse colon	42 (12.3)
Descending colon	22 (6.5)
Sigmoid	45 (13.2)
Rectum	95 (27.9)
LST subtype, n (%)
G-NM	152 (44.6)
G-H	61 (17.9)
NG-PD	62 (18.2)
NG-FE	66 (19.4)
HGD/carcinoma, n (%)	204 (59.8)
Carcinoma in situ, n (%)	173 (50.7)
SMI, n (%)	31 (9.1)
Deep SMI, n (%)	12 (3.5)
Endoscopically unresectable, n (%)	16 (4.7)

LST: Laterally spreading tumor; G-NM: Granular nodular mixed; G-H: Granular homogenous; NG-FE: Non-granular flat elevated; NG-PD: Non-granular pseudodepressed; IQR: Interquartile range; SMI: Submucosal invasion.

Table 2 Characteristics of laterally spreading tumor subtypes

	G-NM (n = 152)	G-H (n = 61)	NG-PD (n = 62)	NG-FE (n = 66)
Size, median (IQR), cm	2.5 (1.8-4.0)	1.8 (1.5-2.4)	1.8 (1.5-2.5)	1.5 (1.3-1.9)
Location, n (%)
Right-sided colon	61 (40.1)	42 (68.9)	32 (51.6)	44 (66.7)
Caecum	25 (16.4)	16 (26.2)	4 (6.4)	4 (6.1)
Ascending colon	31 (20.4)	19 (31.1)	12 (19.4)	26 (39.4)
Transverse colon	5 (3.3)	7 (11.5)	16 (25.8)	14 (21.2)
Descending colon	5 (3.3)	3 (4.9)	5 (8.1)	9 (13.6)
Rectosigmoid	86 (56.6)	16 (26.2)	25 (40.3)	13 (19.7)
Sigmoid	21 (13.8)	4 (6.6)	11 (17.7)	9 (13.6)
Rectum	65 (42.8)	12 (19.7)	14 (22.6)	4 (6.1)
HGD/carcinoma rate, n (%)	117 (77.0)	18 (29.5)	53 (85.5)	16 (24.2)
Carcinoma in situ, n (%)	106 (69.7)	18 (29.5)	35 (56.4)	14 (21.2)
SMI rate, n (%)	11 (7.2)	0 (0)	18 (29.0)	2 (3.0)
Deep SMI rate, n (%)	4 (2.6)	0 (0)	8 (12.9)	0 (0)
Endoscopically unresectable, n (%)	7 (4.6)	0 (0)	9 (14.5)	0 (0)

LST: Laterally spreading tumor; G-NM: Granular nodular mixed; G-H: Granular homogenous; NG-FE: Non-granular flat elevated; NG-PD: Non-granular pseudodepressed; IQR: Interquartile range; HGD: High-grade dysplasia; SMI: Submucosal invasion.

Table 3 Univariate and multivariate analyses of predictors for high-grade dysplasia /carcinoma

	Univariate		Multivariate
	OR (95%CI)	P value	OR (95%CI)	P value
LST subtype
NG-FE	1	-	1	-
NG-PD	18.4 (7.4-45.4)	< 0.001	16.8 (6.5-43.5)	< 0.001
G-NM	10.4 (5.3-20.6)	< 0.001	7.8 (3.8-16.1)	< 0.001
G-H	1.3 (0.6-2.9)	0.504	1.1 (0.5-2.4)	0.871
Location
Non-rectosigmoid	1	-
Rectosigmoid	2.3 (1.5-3.7)	< 0.001
Size, cm
< 2	1	-	1	-
≥ 2	2.6 (1.6-4.0)	< 0.001	2.2 (1.3-3.9)	0.005
Non-lifting sign
Negative	1	-	1	-
Positive	4.0 (1.6-9.8)	0.003	3.3 (1.2-9.2)	0.024

LST: Laterally spreading tumor; G-NM: Granular nodular mixed; G-H: Granular homogenous; NG-FE: Non-granular flat elevated; NG-PD: Non-granular pseudodepressed; OR: Odds ratio; CI: Confidence interval.

Table 4 Univariate and multivariate analyses of predictors for submucosal invasion and deep submucosal invasion

	Univariate		Multivariate
	OR (95%CI)	P value	OR (95%CI)	P value
Risk factors for SMI
LST subtype
Non-NG-PD	1	-	1	-
NG-PD	8.6 (3.9-18.7)	< 0.001	9.1 (3.9-21.0)	< 0.001
Location
Non-rectosigmoid	1	-	1	-
Rectosigmoid	2.9 (1.3-6.3)	0.007	3.2 (1.4-7.6)	0.007
Non-lifting sign
Negative	1	-	1	-
Positive	4.8 (2.0-11.3)	< 0.001	3.0 (1.2-8.0)	0.023
Risk factors for deep SMI
LST subtype
Non-NG-PD	1		1
NG-PD	11.3 (3.3-39.1)	< 0.001	13.3 (3.7-47.9)	< 0.001
Location
Non-rectosigmoid	1		1
Rectosigmoid	7.8 (1.7-36.2)	0.009	8.7 (1.8-42.3)	0.007
Non-lifting sign
Negative	1
Positive	5.2 (1.5-18.6)	0.010

LST: Laterally spreading tumor; NG-PD: Non-granular pseudodepressed; OR: Odds ratio; CI: Confidence interval; SMI: Submucosal invasion.

Table 5 Univariate and multivariate analyses of predictors for endoscopically unresectable laterally spreading tumors

	Univariate		Multivariate
	OR (95%CI)	P value	OR (95%CI)	P value
LST subtype
Non-NG-PD	1	-	1	-
NG-PD	7.2 (2.6-20.3)	< 0.001	7.1 (2.3-22.0)	0.001
Location
Non-rectosigmoid	1	-	1	-
Rectosigmoid	11.1 (2.5-49.7)	0.002	10.5 (2.2-49.0)	0.003
Non-lifting sign
Negative	1	-	1	-
Positive	6.3 (2.1-18.6)	0.001	3.5 (1.0-12.0)	0.045

LST: Laterally spreading tumor; NG-PD: Non-granular pseudodepressed; OR: Odds ratio; CI: Confidence interval.