Comparison of the histopathological characteristics of large colorectal laterally spreading tumors according to growth pattern

Tomoya Saito; Kiyonori Kobayashi; Miwa Sada; Yasuhiro Matsumoto; Miyuki Mukae; Kana Kawagishi; Kaoru Yokoyama; Wasaburo Koizumi; Makoto Saegusa; Yoshitaka Murakami

doi:10.23922/jarc.2018-036

ORIGINAL RESEARCH ARTICLE

Comparison of the histopathological characteristics of large colorectal laterally spreading tumors according to growth pattern

Tomoya Saito, Kiyonori Kobayashi, Miwa Sada, Yasuhiro Matsumoto, Miyuki Mukae, Kana Kawagishi, Kaoru Yokoyama, Wasaburo Koizumi, Makoto Saegusa, Yoshitaka Murakami

Author information

Tomoya Saito
Department of Gastroenterology, Kitasato University, School of Medicine
Kiyonori Kobayashi
Research and Development Center for New Medical Frontiers, Kitasato University, School of Medicine
Miwa Sada
Department of Gastroenterology, Kitasato University, School of Medicine
Yasuhiro Matsumoto
Department of Gastroenterology, Kitasato University, School of Medicine
Miyuki Mukae
Department of Gastroenterology, Kitasato University, School of Medicine
Kana Kawagishi
Department of Gastroenterology, Kitasato University, School of Medicine
Kaoru Yokoyama
Department of Gastroenterology, Kitasato University, School of Medicine
Wasaburo Koizumi
Department of Gastroenterology, Kitasato University, School of Medicine
Makoto Saegusa
Department of Pathology, Kitasato University, School of Medicine
Yoshitaka Murakami
Department of Medical Statistics, Toho University, School of Medicine

Keywords: large colorectal laterally spreading tumors, growth pattern, histopathological characteristics, biological malignancy

JOURNAL OPEN ACCESS

2019 Volume 3 Issue 4 Pages 152-159

DOI https://doi.org/10.23922/jarc.2018-036

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Abstract

Objectives: Colorectal laterally spreading tumors (LSTs) are widely recognized owing to their structural characteristics. This study aims to clarify the histopathological characteristics of large colorectal LSTs according to growth pattern. Methods: We studied 297 colorectal LSTs measuring ≥20 mm in diameter. The LSTs were classified into four types: granular homogenous type (LST-G-H), granular nodular mixed type (LST-G-M), non-granular flat elevated type (LST-NG-F), and non-granular pseudo-depressed type (LST-NG-PD). Retrospectively collected data were examined to compare the histopathological characteristics of LSTs according to the growth pattern. Results: LST-G-M lesions (142 lesions) were most common, followed by LST-NG-F (74 lesions), LST-G-H (61 lesions), and LST-NG-PD (20 lesions). The mean tumor diameter of LST-G lesions (38.5 ± 17.2 mm) was significantly greater than that of LST-NG lesions (26.3 ± 7.0 mm, P < 0.001). In particular, 45% of LST-G-M lesions were ≥40 mm in diameter. Adenomas accounted for 54% of LST-G-H lesions compared with only 10% of LST-NG-PD lesions. Pathological T1 carcinomas accounted for 55% of LST-NG-PD lesions and were not found among LST-G-H lesions. Conclusions: The biological malignancy of colorectal LSTs differs considerably depending on the growth pattern even among large lesions and therefore should be considered when selecting treatment regimens.

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