Retrospective analysis of histopathological spectrum of premalignant and malignant colorectal lesions

Abstract

Background: Colorectal cancers (CRCs) arise due to the progression of acquired or hereditary premalignant lesions. Therefore, an early diagnosis is essential to devise suitable preventive strategies against CRC. Objectives: We aimed at determining the prevalence and pattern of distribution of premalignant and malignant colorectal lesions and to assess their histopathological features. Materials and Methods: This retrospective study was conducted in the Department of Pathology at the Gujarat Cancer Society Medical College, Hospital and Research Center, a tertiary care hospital in Ahmedabad, Gujarat, India, between August 2018 and July 2020. Patients with malignant or premalignant lesions in the colorectal region who underwent biopsy and surgical resection were included, regardless of their age and sex. They were categorized as premalignant or malignant after the histopathological examination. The clinical history and details related to the age, gender, and anatomical site were obtained from the hospital records. The findings were analyzed using descriptive statistics. Results: A total of 150 colorectal biopsies and resected specimens with premalignant and malignant lesions were included in the analysis. Of these, 36 (24%) were benign and 114 (76%) were malignant. There were 98 (65.3%) male and 52 (34.7%) female patients in the cohort. There were 34.7% of the patients who were in the sixth decade of life and only 0.7% were in the first decade. The most commonly involved site was the rectum (32.7%). Ulcerative colitis (UC) (63.8%) was the most common premalignant lesion, and adenocarcinoma not otherwise specified (79.8%) was the most common malignant colorectal lesion. Conclusions: Premalignant and malignant colorectal lesions usually develop in older persons and have a male predilection, with the rectum being the most commonly involved site. UC is the most common premalignant colorectal lesion, and adenocarcinoma is the most common malignant colorectal lesion.