Evaluation of tumor development from the viewpoint of the three-dimensional configuration of isolated crypts in colorectal adenomas with a type IIIL pit pattern.
BACKGROUND
The relationship between the three-dimensional configurations of superficial and protruded-type colon tumors with a type IIIL pit pattern was examined to evaluate their morphological development.


METHODS
Forty-five isolated crypts of superficial-type adenomas and 65 isolated crypts of protruded-type adenomas were evaluated, all derived from segments of 12 colorectal lesions removed by surgery or endoscopic resection. For isolation of the crypts, an HCl-digestion method was used. Morphological features of the isolated crypts were observed by scanning electron microscopy (SEM). We investigated the configuration, length, and width of the isolated crypts in a comparison of the superficial and protruded-type tumors. The configuration and surface structure of the crypts were classified into three types (scores 1 to 3) by the shape and degree of branching and protuberances on their surface.


RESULTS
The average lengths of the isolated crypts of the superficial and protruded types were 310.9 +/- 122.9 micro m ( n = 45) and 434.4 +/- 163.3 micro m ( n = 65), respectively ( P < 0.001), and the average widths of the superficial and protruded types were 140.4 +/- 68.2 micro m and 171.5 +/- 73.3 micro m, respectively ( P = 0.02). The average scores for the degree of branching and protruberances in the superficial and protruded types were 1.178 +/- 0.442 and 1.569 +/- 0.529, respectively ( P < 0.0001). In terms of configuration, in the isolated crypts, the superficial-type tumors exhibited a two-layer structure and the protruded type had the shape of a spindle with protuberances.


CONCLUSIONS
In colorectal tumors with a type IIIL pit pattern, the isolated crypts of protruded-type tumors displayed more roughness on their surface structure and were longer than those of superficial-type tumors. This suggested that the three-dimensional configuration of the isolated crypt constitutes an important factor in the formation of the gross configuration of colorectal tumors. Colorectal superficial and protruded-type tumors may develop with different growth patterns.
Tadokoro
Takehisa
T
Department of Gastroenterology and Hepatology, Kochi Medical School, Kochi, Japan.
Tamura
Satoru
S
Furuya
Yasuo
Y
Araki
Keijiro
K
Onishi
Saburo
S
D000236:Adenoma / Q000473:pathology* / Q000601:surgery; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000473:pathology* / Q000601:surgery; D006801:Humans; D021621:Imaging, Three-Dimensional