Early colorectal cancer: concept, diagnosis, and management

Kashida, Hiroshi; Kudo, Shin‐ei

doi:10.1007/s10147-005-0550-5

Cited by 82 publications

(82 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…These suggestions are also applicable for cancers alternatively evolving through a corresponding nonpolypoid adenoma, instead of direct de novo development (14). The clinical significance of nonpolypoid lesions, emphasized in recent studies (21,30), is expected to be further elucidated by the ongoing prospective Japan Polyp Study (31), evaluating CRC surveillance strategies after initial colonoscopic removal of the detected neoplasia.…”

Section: Discussionmentioning

confidence: 99%

“…At the genetic level, de novo carcinogenesis has been associated with specific molecular characteristics, such as a reduced proportion of Ki-Ras mutation (9,(13)(14)(15) [a key genetic event of the adenoma-carcinoma sequence (3)]. Moreover, de novo lesions exhibited a predilection for proximal tumor location (7,16), an association strongly suggesting genetic disparity, given the considerable predominance of the microsatellite instability (MSI) and CpG island methylator phenotype (CIMP) tumorigenic pathways among proximal tumors (4).…”

Section: Introductionmentioning

confidence: 99%

“…Clinically, de novo tumors may represent a more aggressive (fast-growing at an early stage) subtype of CRC (14,15,20). Consequently, their identification may be important in the planning of treatment and follow-up (10,12,14).…”

Section: Introductionmentioning

confidence: 99%

“…Consequently, their identification may be important in the planning of treatment and follow-up (10,12,14).…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Clinicopathological differences of colorectal cancers according to tumor origin: Identification of possibly de novo lesions

et al. 2012

View full text Add to dashboard Cite

Abstract. Colorectal cancer (CRC) is considered to develop through the conventional adenoma-carcinoma sequence. However, the existence of de novo carcinogenesis, without any intervening precursor lesions, has been suggested for certain morphologically different tumors lacking polypoid characteristics. The presence of such tumors, along with their correlation with cardinal clinicopathological parameters, such as stage, grade and site, was retrospectively investigated in a series of 119 surgically treated CRC cases. The absence of particular polypoid characteristics (adenomatous remnants or coexisting polyps in the tumor vicinity) in combination with an infiltrative (or ulceroinfiltrative) growth pattern, were the criteria defining the nonpolypoid origin. The recorded frequencies of remnants, coexisting polyps and infiltrative tumors were 7, 5, 9 and 32%, respectively. The incidence of cases meeting the above-mentioned criteria was 28.5%. These nonpolypoid lesions exhibited a predilection for proximal anatomical site (P=0.04), probably associated with their infiltrative pattern. Most importantly, de novo lesions (unlike polypoid) were rarely found among cases with indolent tumor characteristics (stage I or grade I, P=0.008), showing a considerably different overall pattern of distribution by stage and grade as compared to that of polypoid tumors (P=0.03). The fact that nonpolypoid CRCs appeared to be clinicopathologically different from their polypoid counterparts is supportive of possible de novo origin and suggestive of a likely worse clinical behavior. The impact of these findings should be investigated to determine potential applications in the diagnosis, treatment and surveillance of these lesions.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Consequently, their identification may be important in the planning of treatment and follow-up (10,12,14).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Clinicopathological differences of colorectal cancers according to tumor origin: Identification of possibly de novo lesions

et al. 2012

View full text Add to dashboard Cite

show abstract

“…Currently, pit pattern diagnosis by magnifying chromoendoscopy is the gold standard for differentiating neoplasms from non-neoplasms and for estimating invasive depth of colorectal cancer. Type V N (non-structure) pit pattern is an index of massively invasive lesions in the submucosal layer (12)(13)(14). More recently, it was reported that evaluation of the microstructure and microvessels of the superficial layer, which can be recognised using NBI, was useful for diagnosing invasion depth of colorectal tumours (15,16).…”

Section: Introductionmentioning

confidence: 99%

Magnifying narrow-band imaging of surface patterns for diagnosing colorectal cancer

et al. 2013

Self Cite

View full text Add to dashboard Cite

Abstract. Na r row-band imaging (N BI) of sur face microvessels of colorectal lesions is useful for differentiating neoplasms from non-neoplasms and for predicting histopathological diagnosis. Furthermore, NBI of surface microstructure, or 'surface pattern', is valuable for predicting histopathology in colorectal cancer. The aim of the present study was to investigate whether surface patterns could be used to predict invasion depth in colorectal cancer, and to compare the accuracy of surface pattern diagnosis in each macroscopic type. Between January 2010 and March 2011, a series of 357 consecutive patients with 378 early colorectal cancers were observed by magnifying NBI and the surface pattern was prospectively evaluated. Surface pattern was classified into 3 types: type I, microstructure was clearly recognised with uniform arrangement and form; type II, microstructure was obscured with heterogeneous arrangement and form; and type III, microstructure was invisible. We also classified the macroscopic type into 3 categories: depressed, protruded and flat elevated. Assuming that type III was an index of massively invasive lesions in the submucosal layer (SMm), the sensitivity, specificity and accuracy were 56.9, 91.7 and 85.7%, respectively. The sensitivity, specificity and accuracy of type III for the diagnosis of SMm in each macroscopic type were: depressed, 88.9, 40.0 and 63.2%, respectively; protruded: 34.8, 96.4 and 90.0%, respectively; and flat elevated, 54.2, 92.7 and 85.0%, respectively. These results suggest that the diagnostic accuracy of surface pattern was insufficient and particularly poor for depressed-type lesions. IntroductionNarrow-band imaging (NBI) of surface microvessels of colorectal lesions is useful for differentiating neoplasms from non-neoplasms and for predicting histopathological diagnosis (1-8). We have reported that analysis of vascular patterns by magnifying NBI is useful for characterization of colorectal lesions (9-11). Currently, pit pattern diagnosis by magnifying chromoendoscopy is the gold standard for differentiating neoplasms from non-neoplasms and for estimating invasive depth of colorectal cancer. Type V N (non-structure) pit pattern is an index of massively invasive lesions in the submucosal layer (12-14). More recently, it was reported that evaluation of the microstructure and microvessels of the superficial layer, which can be recognised using NBI, was useful for diagnosing invasion depth of colorectal tumours (15,16). In Japan, surface microstructure observation by magnifying NBI is called 'surface pattern ' (17-20). Some reports have highlighted differences between pit structure observed by chromoendoscopy and surface pattern observed by magnifying NBI (2,(20)(21)(22). In terms of macroscopic type, when we divided the morphology of superficial colorectal lesions into protruded, flat elevated and depressed, there were differences between typical pit patterns of depressed lesions and the others (13,23,24). We hypothesised that the surface pattern could be different betwe...

show abstract