Evaluation of new subclassification of type VI pit pattern for determining the depth and type of invasion of colorectal neoplasm

• DOI: 10.1007/s00535-010-0300-y
• Publication Date: 2010-08-13T01:46:02Z
• Authors: Kenshi Matsumoto; Akihito Nagahara; Takeshi Terai; Hiroya Ueyama; Hideaki Ritsuno; Hiroki Mori; Kohsaburo Nakae; Kazuko Beppu; Tomoyoshi Shibuya; Naoto Sakamoto; Taro Osada; Tatsuo Ogihara; Takashi Yao; Sumio Watanabe
• Keywords: Adenoma; Male; Carcinoma; Colonoscopy; Middle Aged; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Humans; Female; Neoplasm Invasiveness; Intestinal Mucosa; Colorectal Neoplasms; Neoplasm Staging; Retrospective Studies

Colorectal neoplasms with a type V(I) pit pattern include various lesions, such as adenomas, intramucosal cancers, and submucosal carcinomas.We analyzed 96 colorectal neoplasms with a type V(I) pit pattern and identified six different variants: (1) unclear outline of the pit; (2) irregular margins of the pit; (3) narrowing of the pit; (4) ragged array of the pit; (5) high residual density of the pit; (6) abnormal branching of the pit. We examined the relationship between the appearance of each V(I) pit pattern and histology, including the depth of invasion.In univariate logistic regression analysis the unclear outline, irregular margins, and narrowing of the pit were significantly associated with a submucosal (SM) invasion ≥1000 μm (P < 0.01). In multivariate logistic regression analysis, unclear outline of the pit was shown to be the only significant predictor of highly invasive submucosal cancer (odds ratio = 24.20, P < 0.0001). Regarding tumor morphology, the following were significantly associated with an SM invasion ≥1000 μm: in protruded type, ragged array (P = 0.022), irregular margins of the pit (P = 0.011), and unclear outline of the pit (P < 0.01); in flat type, irregular margins of the pit (P < 0.01) and unclear outline of the pit (P < 0.01); and in the depressed type, narrowing of the pit (P = 0.015) and unclear outline of the pit (P < 0.01).Subclassification of the type V(I) pit pattern is useful for determining the depth of invasion of colorectal neoplasms.