Detection of desmoplastic reaction in biopsy specimens is useful for predicting the depth of invasion of early colorectal cancer: a Japanese collaborative study.
BACKGROUND
We have previously demonstrated a relationship between the depth of submucosal invasion (SM depth) and the frequency of lymph node metastasis in resected submucosal invasive colorectal cancers (SICRCs). Here, we assessed the desmoplastic reaction (DR) in pretreatment biopsy specimens of SICRC to predict the SM depth.


METHODS
A total of 359 patients with SICRCs, who had undergone surgical or endoscopic mucosal resection, were enrolled. The SM depth of the SICRC lesions was evaluated according to the procedure established by the Japanese Society for Cancer of the Colon and Rectum, and the patients' corresponding pretreatment biopsy specimens were examined histologically to evaluate the prevalence of DR.


RESULTS
For pedunculated SICRCs, the prevalence of DR in pretreatment biopsy specimens was significantly higher in moderately differentiated than in well-differentiated adenocarcinomas, but was not significantly related to SM depth. For nonpedunculated SICRCs, the prevalence of DR in pretreatment biopsy specimens was significantly related to histological type, tumor size, and SM depth. When non-pedunculated SICRCs were further divided using a specific cutoff value of 1000 μm for SM depth, the DR positivity rate in pretreatment biopsy specimens was significantly higher in SICRCs with an SM depth of ≥1000 μm (termed "SM massive CRCs") than in cases where the SM depth was <1000 μm (termed "SM slight CRCs").


CONCLUSIONS
Detection of DR in pretreatment biopsy specimens is useful for the prediction of SM depth in nonpedunculated SICRCs, and may be useful for the selection of such cases that would be treatable by endoscopic mucosal resection and endoscopic submucosal dissection (EMR/ESD).
Hirose
Motohiko
M
Department of Surgical and Molecular Pathology, Dokkyo University School of Medicine, 880 Kitakobayshi, Mibu, Shimotsuga, Tochigi, 321-0293, Japan.
Fukui
Hirokazu
H
Igarashi
Yoshinori
Y
Fujimori
Yukari
Y
Katake
Yoshinori
Y
Sekikawa
Akira
A
Ichikawa
Kazuhito
K
Tomita
Shigeki
S
Imura
Johji
J
Ajioka
Yoichi
Y
Ueno
Hideki
H
Hase
Kazuo
K
Ohkura
Yasuo
Y
Kashida
Hiroshi
H
Togashi
Kazutomo
K
Nishigami
Takashi
T
Matsui
Toshiyuki
T
Yao
Takashi
T
Wada
Ryo
R
Matsuda
Keiji
K
Watanabe
Toshiaki
T
Ochiai
Atsushi
A
Sugai
Tamotsu
T
Sugihara
Kenichi
K
Fujimori
Takahiro
T
D000230:Adenocarcinoma / Q000473:pathology*; D000368:Aged; D001706:Biopsy; D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D015995:Prevalence; D012189:Retrospective Studies