Endoscopic Diagnosis of the Invasion Depth of T1 Colorectal Carcinoma for Endoscopic Resection by Using Narrow-Band Imaging Magnification as Total Excisional Biopsy

摘要

Background/Aims:We established a new colorectal T1 invasion depth sub-classification and evaluated it to determine whethertotal excisional biopsy can be performed on colorectal carcinoma (CRC) cases using narrow-band imaging (NBI) magnification. Methods: The cases included 73 T1 carcinomas selected from 173 early CRC cases. The T1 invasion depth sub-classification was defined as follows: T1a, invasion less than 1,000 pm from the inferior border of the muscularis mucosae; T1b-1, between T1a and T1b-2; and T1b-2, T1b lesions with invasion from the deepest part of the carcinoma to within 1,000 pm of the superior border of the muscularis propria. The T1b-2 lesions were not suitable for total excisional biopsy to be performed on them. We examined the maximum diameter of Type C2 (NBI Hiroshima classification) areas and invasion depth. Results: Among 47 lesions classified as Type C2, 38 lesions showed a maximum diameter of 10 mm or less and were classified as Tis, T1a, or T1b-1. The remaining 9 lesions exceeded 10 mm, and among these, 3 cases were classified as T1b-2 (p = 0.0035). Conclusion: For using the new T1 invasion depth sub-classification to classify T1 CRCs in which total excisional biopsy is possible, it is useful to measure the maximum diameter of the Type C2 area. (C) 2016 S. Karger AG, Basel