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Suzuki Y, Ishida F, Ishida H, Ueno H, Kobayashi H, Yamaguchi T, Konishi T, Kanemitsu Y, Hinoi T, Inoue Y, Tomita N, Sugihara K. Morphological Analyses of Colorectal Adenocarcinomas in Japanese Familial Adenomatous Polyposis Patients. J Anus Rectum Colon 2022; 6:121-128. [PMID: 35572485 PMCID: PMC9045858 DOI: 10.23922/jarc.2021-047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 11/15/2021] [Indexed: 12/02/2022] Open
Abstract
Objectives: This retrospective study was conducted to clarify the morphological characteristics of colorectal cancer (CRC) in Japanese familial adenomatous polyposis (FAP) patients. Methods: This study was carried out by the study group for FAP of the Japanese Society for Cancer of the Colon and Rectum. FAP patients who underwent surgical resection between 2000 and 2012 were included in the study. Results: Of the 303 patients enrolled, 119 patients without CRC were excluded. Of 523 lesions, 49 lesions with missing morphological information were excluded; hence, only 474 CRC lesions in 178 patients (328 superficial lesions in 122 patients and 146 non-superficial lesions in 92 patients) were included in the study. Depressed lesions accounted for 3.0% of superficial lesions and ulcerated lesions accounted for 84.9% of non-superficial lesions. The depressed superficial lesions were observed only in patients with sparse and attenuated FAP (P = 0.003). The age of the patients at surgery differed between the two groups, with patients with depressed superficial lesions being significantly older than those with non-depressed superficial lesions (P = 0.009). Moreover, the age of the patients at FAP diagnosis differed between the two groups, with patients with ulcerated non-superficial lesions being significantly older than those with protruded non-superficial lesions (P = 0.006). Conclusions: In patients with FAP, depressed superficial CRC lesions rarely developed but were detected in our study group, and ulcerated non-superficial CRC lesions were also present with similar ratios. Clinicians should pay attention to depressed superficial lesions during endoscopic surveillance of FAP patients.
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Affiliation(s)
- Yozo Suzuki
- Department of Surgery, Toyonaka Municipal Hospital
| | - Fumio Ishida
- Study Group for Familial Adenomatous Polyposis of the Japanese Society for Cancer of the Colon and Rectum
| | - Hideyuki Ishida
- Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University
| | - Hideki Ueno
- Study Group for Familial Adenomatous Polyposis of the Japanese Society for Cancer of the Colon and Rectum
| | | | - Tatsuro Yamaguchi
- Study Group for Familial Adenomatous Polyposis of the Japanese Society for Cancer of the Colon and Rectum
| | - Tsuyoshi Konishi
- Study Group for Familial Adenomatous Polyposis of the Japanese Society for Cancer of the Colon and Rectum
| | - Yukihide Kanemitsu
- Study Group for Familial Adenomatous Polyposis of the Japanese Society for Cancer of the Colon and Rectum
| | - Takao Hinoi
- Department of Gastroenterological and Transplant Surgery, Hiroshima University
| | - Yasuhiro Inoue
- Study Group for Familial Adenomatous Polyposis of the Japanese Society for Cancer of the Colon and Rectum
| | | | - Kenichi Sugihara
- Study Group for Familial Adenomatous Polyposis of the Japanese Society for Cancer of the Colon and Rectum
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Kodama K, Kudo SE, Miyachi H, Wakamura K, Maeda Y, Ichimasa K, Ogawa Y, Kouyama Y, Abe M, Ogura Y, Okumura T, Mochizuki K, Minegishi Y, Ishiyama M, Mori Y, Misawa M, Kudo T, Hayashi T, Ishida F, Watanabe D. Clinical and endoscopic characteristics of post-colonoscopy colorectal cancers detected within 10 years after a previous negative examination. Endosc Int Open 2021; 9:E1472-E1479. [PMID: 34540538 PMCID: PMC8445690 DOI: 10.1055/a-1518-6754] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 02/01/2021] [Indexed: 12/21/2022] Open
Abstract
Abstract
Background and study aims We sometimes encounter colorectal cancer (CRC) that is discovered during the time interval between initial colonoscopy and the recommended follow-up examination. Although several studies reported such cases of CRC, most were based on registry data, which implied that the endoscopic quality was not consistent or guaranteed. We aimed to clarify these clinical and endoscopic characteristics at our high-volume center where a retrospective survey could be precisely performed.
Patients and methods We retrospectively analyzed patients with CRC who underwent endoscopic resection or surgery from April 2002 to December 2010, categorizing them into two groups: a “study group” of patients with a negative colonoscopy during the previous 10 years, and a “control group” of patients without a previous colonoscopy or with a previous colonoscopy more than 10 years prior.
Results A total of 2042 patients had CRC, among which 55 patients were classified into the study group and the remaining 1989 into the control group. The CRC cases in the study group showed a significant association with smaller (< 30 mm) tumor size (odds ratio [OR] 2.3; 95 % confidence interval [CI] 1.3–4.0) and proximal tumor site (OR 1.7; 95 %CI 0.9–2.9). In addition, right-sided and depressed-type T1 CRCs were significantly more common in the study group.
Conclusions Tumor size and location were associated with CRCs detected within 10 years after the negative examination. In addition, depressed-type T1 CRCs were more common. Therefore, we should pay more attention to small, right-sided, or depressed-type tumors in daily colonoscopy.
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Affiliation(s)
- Kenta Kodama
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan
- Division of Gastroenterology, Japanese Red Cross Society Fukushima Hospital, Fukushima, Japan
| | - Shin-ei Kudo
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan
| | - Hideyuki Miyachi
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan
| | - Kunihiko Wakamura
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan
| | - Yasuharu Maeda
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan
| | - Katsuro Ichimasa
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan
| | - Yushi Ogawa
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan
| | - Yuta Kouyama
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan
| | - Masahiro Abe
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan
| | - Yohei Ogura
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan
| | - Taishi Okumura
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan
| | - Kenichi Mochizuki
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan
| | - Yosuke Minegishi
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan
| | - Misaki Ishiyama
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan
| | - Yuichi Mori
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan
| | - Masashi Misawa
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan
| | - Toyoki Kudo
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan
| | - Takemasa Hayashi
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan
| | - Fumio Ishida
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan
| | - Daisuke Watanabe
- Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
- Division of Gastroenterology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, United States
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Sugihara Y, Kudo SE, Miyachi H, Wakamura K, Mori Y, Misawa M, Hisayuki T, Kudo T, Hayashi T, Hamatani S, Okoshi S, Okada H. In vivo detection of desmoplastic reaction using endocytoscopy: A new diagnostic marker of submucosal or more extensive invasion in colorectal carcinoma. Mol Clin Oncol 2017; 6:291-295. [PMID: 28451401 PMCID: PMC5403294 DOI: 10.3892/mco.2017.1138] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Accepted: 11/29/2016] [Indexed: 12/12/2022] Open
Abstract
The pathological determination of desmoplastic reaction (DR) in colorectal carcinoma is useful for predicting extensive submucosal invasion. The aim of the present study was to determine the usefulness of endocytoscopy (EC) in detecting DR. A total of 72 cases of colorectal cancer with submucosal invasion (EC classification, EC3b) were evaluated. The utility of fine granular structure (FGS) observed via EC for the prediction of the presence of DR in the most superficial tumor layers was assessed. Of the 72 lesions, 26 were positive for FGS, and the majority of these lesions (23/26, 88.5%) exhibited a DR, indicating a significant association. The overall accuracy of the identification of FGS via EC that was predictive of a DR was 87.3%. The presence of FGS detected by EC was significantly associated with the presence of a DR, suggesting the clinical usefulness of EC in planning treatment for colon cancer with submucosal invasion.
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Affiliation(s)
- Yuusaku Sugihara
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa 224-0032, Japan.,Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Shin-Ei Kudo
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa 224-0032, Japan
| | - Hideyuki Miyachi
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa 224-0032, Japan
| | - Kunihiko Wakamura
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa 224-0032, Japan
| | - Yuichi Mori
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa 224-0032, Japan
| | - Masashi Misawa
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa 224-0032, Japan
| | - Tomokazu Hisayuki
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa 224-0032, Japan
| | - Toyoki Kudo
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa 224-0032, Japan
| | - Takemasa Hayashi
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa 224-0032, Japan
| | - Shigeharu Hamatani
- Department of Pathology, The Jikei University School of Medicine, Tokyo 105-8461, Japan
| | - Shogo Okoshi
- Department of Internal Medicine, School of Life Dentistry at Niigata, The Nippon Dental University, Niigata 951-1500, Japan
| | - Hiroyuki Okada
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
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