ArticleTechniques in coloproctology2012
More advanced or aggressive colorectal cancer is associated with a higher incidence of "high-grade intraepithelial neoplasia" on biopsy-based pathological examination.
Article in Techniques in coloproctology, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 9 papers.
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9 citing papers in PubMed, 10 citations in OpenAlex.
- Preoperative risk stratification of colorectal high-grade intraepithelial neoplasia based on endoscopic biopsy: superior performance ofQuantitative imaging in medicine and surgery · 2025Article
- A joint photoacoustic imaging and broadband spectral analysis for early-stage intraoperative pathology assessment: A case study with colorectal cancer.Photoacoustics · 2025Article
- Microenvironment-induced restoration of cohesive growth associated with focal activation of P-cadherin expression in lobular breast carcinoma metastatic to the colon.The journal of pathology. Clinical research · 2024Article
- A new practical classification of desmoplastic reaction in endoscopic forceps biopsy of colorectal cancer.Histology and histopathology · 2021Article
- Exploration of the Key Proteins of High-Grade Intraepithelial Neoplasia to Adenocarcinoma Sequence Using In-Depth Quantitative Proteomics Analysis.Journal of oncology · 2021Article
- Can transrectal ultrasound-guided core needle biopsy serve as an accurate diagnostic tool for rectal lesions?Annals of translational medicine · 2020Article
- Histopathologic discrepancy between endoscopic forceps biopsy and final pathology and the role of transrectal ultrasound-guided core needle biopsy.Annals of translational medicine · 2020Article
- Diagnostic value, safety, and histopathologic discrepancy risk factors for endoscopic forceps biopsy and transrectal ultrasound-guided core needle biopsy in rectum lesions.Annals of translational medicine · 2019Article
- Malignant recurrence and distal metastasis after complete local resection of colorectal "high-grade intraepithelial neoplasia": incidence and risk factors.International journal of colorectal disease · 2014Article
Corrections and comments
- Erratum issued
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8 authors at 2 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundInvasion of submucosa (ISM) is required for the pathological diagnosis of colorectal cancer according to the WHO criteria. A large proportion of colorectal cancers may be underdiagnosed as high-grade intraepithelial neoplasia (HGIN) because ISM is not identified in the preoperative biopsy. The aim of this study was to investigate the clinicopathologic features that are associated with missing the diagnosis of ISM in biopsy specimens of invasive colorectal cancer.
methodsThree hundred and sixteen patients diagnosed with colorectal cancer between January 2007 and December 2008 with well-preserved preoperative biopsy specimens were enrolled in the study. Three hundred and eleven patients had an isolated lesion, and five had two lesions. Biopsy specimens were reevaluated by two senior pathologists. Clinicopathologic features, biopsy pathology and surgical pathology results of all patients were analyzed by univariate and multivariate analyses.
resultsISM was identified in 216 cases (67.3 %) by biopsy-based pathological examination, and missed in 105 (32.7 %) cases, 72 of which were diagnosed as HGIN. Univariate analysis indicated that in colorectal cancer patients with smaller biopsy specimens (P = 0.042), mucinous or signet-ring cell carcinoma (P = 0.003), higher WHO tumor grade (P = 0.001) and positive lymph nodes (P = 0.011), ISM was more likely to be missed. There was a trend toward an increased diagnosis of ISM with the increase in the number of biopsy specimens (P = 0.105). On multivariate logistic regression analysis, smaller biopsy specimens (OR, 1.810; 95 % CI, 1.081-3.032; P = 0.024) and higher WHO tumor grade (OR, 2.073; 95 % CI, 1.046-4.107; P = 0.037) were the only factors associated with failure to identify ISM.
conclusionsA large number of invasive colorectal cancers are at risk of being underdiagnosed as HGIN by biopsy-based pathology. The smaller the biopsy size, the less likely it is that the muscularis mucosae is included in the specimen. Also, in the more advanced or aggressive colorectal cancers, ISM is more likely to be missed on biopsy, which may be due to the destruction of the muscularis mucosae by more aggressive cancers.
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