Sub-classification of type VI pit patterns in colorectal tumors: relation to the depth of tumor invasion

Abstract

Abstract. We analyzed pit patterns of colorectal tumors with magnifying colonoscopy, focusing on the relationship between the V I pattern sub-classification and the depth of tumor invasion. The V I pattern was divided into the well-demarcated and poorly demarcated subtypes. The percentage of tumors with a depth of invasion of over 1,000 μm was in the order of non-V types (type I-IV) < type V I < type V N . Most welldemarcated V I lesions (80.8%) showed a depth of invasion of <1,000 μm compared to only 21.1% of poorly demarcated V I lesions. Both the frequency of degeneration or prolapse of the epithelial lining and the frequency of desmoplastic reaction occurred in the order of non-V types < type V I < type V N , while the degree of histological differentiation and the frequency of residual muscularis mucosae occurred in the order of non-V types > type V I > type V N . Furthermore, the poorly demarcated V I subtype showed a higher frequency of epithelial lining degeneration or prolapse and a lower frequency of residual muscularis mucosae than the welldemarcated V I subtype. Tumors with a depth of invasion of >1,000 μm showed a higher frequency of epithelial lining degeneration or prolapse, a lower degree of histological differentiation, a higher frequency of desmoplastic reaction, and a lower frequency of residual muscularis mucosae than did tumors with <1,000 μm of invasion. These results suggest that V I pit pattern sub-classification is a useful indicator of the depth of colorectal tumor invasion and treatment selection. A prospective study on this subject would be useful.

Endoscopic discrimination of sessile serrated adenomas from other serrated lesions

“…Using magnifying chromoendoscopy, pit patterns were classified based on the classification of Kudo et al (14) and Tsuruta et al (15). Type I are regular round crypts, type II are stellar or papillary crypts, type III are small tubular or roundish crypts (III S ) or large tubular or roundish crypts (III L ), type IV consists of branch-or gyrus-like crypts, and type V consists of irregular crypts (V I ) or non-structural crypts (V N ).…”

The Diagnosis and Treatment of Early-Stage Colorectal Cancer

“…Type V I pit patterns allow further subdivision into areas with mild irregularity (type V I mild) and severe irregularity that show destroyed and severely damaged pits (type V I severe). Type V I severe pit patterns were defined by Tobaru et al as areas containing pits with poor demarcation and those which contain faded or unstained stromal areas [15]. Regarding diagnostic standardization by magnifying chromoendoscopy, this classification should be directly linked to the choice of the most appropriate treatment.…”

A Comparison of Magnifying Chromoendoscopy Versus Narrow Band Imaging in the Diagnosis of Depth of Invasion for Early Colorectal Cancers

“…Thus, we included 16 studies in our nal review Table 1 summarizes the included study characteristics. Ten studies were conducted prospectively in clinical settings 2,7,[15][16][17][18][19][20][21][22] , and six studies were based on still images of lesions analyzed retrospectively [23][24][25][26][27][28] . Patient demographics were generally not provided.…”

“…In 2009, approximately 23,000 men and 20,000 women died of this malignancy 1 . During the past decade, great emphasis has been placed on the use of colonoscopy for the early detection and removal of neoplastic polyps to reduce the incidence of and mortality from CRC.…”