title: Detection of desmoplastic reaction in biopsy specimens is useful for predicting the depth of invasion of early colorectal cancer: a Japanese collaborative study.
abstract: 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).
authors.affiliation: Department of Surgical and Molecular Pathology, Dokkyo University School of Medicine, 880 Kitakobayshi, Mibu, Shimotsuga, Tochigi, 321-0293, Japan.
authors.forename: Motohiko
authors.initials: M
authors.lastname: Hirose
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Fukui
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Igarashi
authors.forename: Yukari
authors.initials: Y
authors.lastname: Fujimori
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Katake
authors.forename: Akira
authors.initials: A
authors.lastname: Sekikawa
authors.forename: Kazuhito
authors.initials: K
authors.lastname: Ichikawa
authors.forename: Shigeki
authors.initials: S
authors.lastname: Tomita
authors.forename: Johji
authors.initials: J
authors.lastname: Imura
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Ajioka
authors.forename: Hideki
authors.initials: H
authors.lastname: Ueno
authors.forename: Kazuo
authors.initials: K
authors.lastname: Hase
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Ohkura
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kashida
authors.forename: Kazutomo
authors.initials: K
authors.lastname: Togashi
authors.forename: Takashi
authors.initials: T
authors.lastname: Nishigami
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Matsui
authors.forename: Takashi
authors.initials: T
authors.lastname: Yao
authors.forename: Ryo
authors.initials: R
authors.lastname: Wada
authors.forename: Keiji
authors.initials: K
authors.lastname: Matsuda
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Watanabe
authors.forename: Atsushi
authors.initials: A
authors.lastname: Ochiai
authors.forename: Tamotsu
authors.initials: T
authors.lastname: Sugai
authors.forename: Kenichi
authors.initials: K
authors.lastname: Sugihara
authors.forename: Takahiro
authors.initials: T
authors.lastname: Fujimori
mesh_terms: 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