Clinicopathological risk factors of early carcinoma in colorectal neoplasias according to Japanese and Western criteria.
OBJECTIVE
There are discrepancies in the classification of early carcinoma in colorectal neoplasia between Japanese and Western criteria. However, no studies have investigated the clinicopathological risk factors associated with early carcinoma according to these criteria.


METHODS
We compared the clinicopathological risk factors of early carcinoma with those of dysplasia, and used multivariate analysis to elucidate the independent risk factors associated with early carcinoma. Lesions with severe cytologic or architectural changes confined to the mucosa are classified as carcinoma in Japanese criteria and as high grade dysplasia (HGD) in Western criteria.


RESULTS
Pathologically, 625 total patients were diagnosed with low grade dysplasia (n=321), HGD (n=244), intramucosal carcinoma (n=35) or submucosal carcinoma (n=25). In multivariate analysis, age, large lesion size, and non-polypoid appearance were associated with carcinoma in Japanese criteria; however, only large lesion size was associated with carcinoma in Western criteria. The clinicopathological characteristics of intramucosal carcinoma were similar to those of submucosal carcinoma rather than HGD.


CONCLUSIONS
The clinicopathological characteristics for early carcinoma were not identical between Japanese and Western criteria. Japanese criteria classifying intramucosal carcinoma as carcinoma rather than HGD may be supported by our findings.
Jae Myung
JM
Cha
Joung Il
JI
Lee
Kwang Ro
KR
Joo
Hyun Phil
HP
Shin
Jae Jun
JJ
Park
Jung Won
JW
Jeun
Jun Uk
JU
Lim
D000236:Adenoma / Q000145:classification / Q000473:pathology*; D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000145:classification / Q000473:pathology*; D016009:Chi-Square Distribution; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000145:classification / Q000473:pathology*; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D016017:Odds Ratio; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D009626:Terminology as Topic; D047368:Tumor Burden