Endoscopic Diagnosis of the Invasion Depth of T1 Colorectal Carcinoma for Endoscopic Resection by Using Narrow-Band Imaging Magnification as Total Excisional Biopsy.
OBJECTIVE
We established a new colorectal T1 invasion depth sub-classification and evaluated it to determine whether total excisional biopsy can be performed on colorectal carcinoma (CRC) cases using narrow-band imaging (NBI) magnification.


METHODS
The cases included 73 T1 carcinomas selected from 173 early CRC cases. The T1 invasion depth sub-classification was defined as follows: T1a, invasion less than 1,000 μm from the inferior border of the muscularis mucosae; T1b-1, between T1a and T1b-2; and T1b-2, T1b lesions with invasion from the deepest part of the carcinoma to within 1,000 μm of the superior border of the muscularis propria. The T1b-2 lesions were not suitable for total excisional biopsy to be performed on them. We examined the maximum diameter of Type C2 (NBI Hiroshima classification) areas and invasion depth.


RESULTS
Among 47 lesions classified as Type C2, 38 lesions showed a maximum diameter of 10 mm or less and were classified as Tis, T1a, or T1b-1. The remaining 9 lesions exceeded 10 mm, and among these, 3 cases were classified as T1b-2 (p = 0.0035).


CONCLUSIONS
For using the new T1 invasion depth sub-classification to classify T1 CRCs in which total excisional biopsy is possible, it is useful to measure the maximum diameter of the Type C2 area.
Department of Gastroenterology, Hokusetsu General Hospital, Osaka, Japan.
Makoto
M
Sanomura
Shinji
S
Tanaka
Yuichi
Y
Sasaki
Shinya
S
Fukunishi
Kazuhide
K
Higuchi
D001706:Biopsy / Q000379:methods; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000145:classification / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D009092:Mucous Membrane / Q000473:pathology; D062048:Narrow Band Imaging / Q000379:methods*; D009361:Neoplasm Invasiveness