More advanced or aggressive colorectal cancer is associated with a higher incidence of “high-grade intraepithelial neoplasia” on biopsy-based pathological examination

Wei, Xu; Xian, Gao; Wang, H; Fu, Chuan Gang; Zheng, Wei; Zheng, J M; Zhang, Wei; Liu, L J

doi:10.1007/s10151-012-0827-4

Cited by 12 publications

(8 citation statements)

References 22 publications

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“…Regarding the stomach, a discrepancy of 33.9-49% is reported from the study comparing the EFB outcome and the final result obtained after endoscopic resection (3)(4)(5)(6). On the other hand, the confirmation rate of invasive cancer from preoperative EFB of rectal lesions is reported as 58.7-67.3% (7,8), which is slightly higher than the result obtained from the study on the stomach. Among the three types of discrepancy, upgraded discrepancy is the most problematic.…”

mentioning

confidence: 61%

Histopathologic discrepancy between endoscopic forceps biopsy and final pathology and the role of transrectal ultrasound-guided core needle biopsy

Roh

Noh

2020

Ann Transl Med

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mentioning

confidence: 61%

Histopathologic discrepancy between endoscopic forceps biopsy and final pathology and the role of transrectal ultrasound-guided core needle biopsy

Roh

Noh

2020

Ann Transl Med

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“…According to the WHO 19 an obligatory criterion for the diagnosis of colorectral adenocarcinoma is invasion of the submucosis or beyond, which is an indicator of metastatic potential. If preoperative biopsy does not identify submucosal invasion, there is a great possibility for underestimation of the depth of invasion, and thus invasive carcinoma is diagnosed as high-grade intraepithelial neoplasia 16 .…”

Section: Discussionmentioning

confidence: 99%

“…Lopes Cardoso 5 in 1980s considered colorectal cytology as "a neglected field in the clinical cytology", expecting that introduction of endoscopic technics would change that, since nonpractical lavage of the intestine was substituted by brush cytology. The introduction of novel methods such as endoscopic ultrasousd-guided fine needle aspiration (EUS FNA) and liquid-based cytology, could have been a new impulse for more use of cytological diagnostics 6−8 . Although papers from the last two decades of the last century, as well as from the first decade of this century, point out to high sensitivity to brush cytology of the colorectal region 8−13 , sometimes even higher than to biopsy 14 , complementarity of those two diagnostics as well as insufficiency of small biopsies 15,16 , cytological diagnostics of this region has been declining for the past years 17 .…”

Section: Introductionmentioning

confidence: 99%

The value of brush cytology and biopsy for the diagnosis of colorectal cancer

et al. 2017

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Background/Aim. Although it is well-known the high sensitivity of brush cytology for the diagnosis of colorectal adenocarcinoma, this kind of diagnostics is not routinely used, and for the past years it has even been declining. The purpose of this study was to evaluate the value of brush cytology for the diagnosis of colorectal carcinoma, by comparison the results of brush cytology and biopsy, and then the results of both diagnostic methods with the final patohistological diagnosis of colorectal resection. Methods. This retrospective study included 173 patients with brush cytology of colorectal region during colonoscopy. In 166 patients concomitant biopsy specimens were obtained, and in 116 of them resection of the intestine as well. A total of the 106 patients underwent to all three diagnostic procedures. Results. Out of 166 patients who went through both brush cytology and biopsy, the congruent diagnosis was made in 129 (77.7%) patients: in 109 (65.7%) adenocarcinoma was diagnosed, which was confirmed after the resection of the intestine in 75 of the patients, and in 14 (8.4%) benign lesion, so there was no need for resection of the intestine. In 6 (3.6%) of the patients, both cytology and biopsy were negative, but the resected specimen was malignant. In 10 of the patients with malignant cytology in whom biopsy was not done, resection of the intestine confirmed malignancy. The sensitivity of detecting malignancy by brush cytology and biopsy were 87.9% and 78.3%, respectively (but this difference was not statistically significant, p = 0.083). Both methods had specificity and positive predictive values 100%. Negative predictive values for cytology and biopsy were 50% and 37.8%, respectively. The accuracy of cytology and biopsy was 89.2% and 80.8%, respectively. The combination of the results of brush cytology and biopsy increased the sensitivity of preoperative diagnostics to 94.8% which was significantly higher than sensitivity of biopsy (p < 0.001), but not than sensitivity of cytology (p = 0.102). Conclusion. Brush cytology could be a routine method, along with biopsy, in the diagnosis of colorectal malignancy. Both methods have comparable both sensitivity and accuracy, and its combination increases sensitivity of preoperative diagnostics of colorectal adenocarcinoma, which gives opportunity to better estimation of further diagnostic and therapeutic approach.

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“…However, postoperative pathology reveals that most such lesions are invasive cancers with ISM or deeper layers (7,(9)(10)(11). Evidence shows that invasive cancers can be confirmed only in 58.7-67.3% of rectal tissues collected by EFB before surgery (12,13). Thus, EFB cannot be used as the only standard in the preoperative diagnosis of rectal lesions, as its exclusive use may cause significant underdiagnosis and treatment delay (7,(9)(10)(11)14,15).…”

Section: Introductionmentioning

confidence: 99%

Diagnostic value, safety, and histopathologic discrepancy risk factors for endoscopic forceps biopsy and transrectal ultrasound-guided core needle biopsy in rectum lesions

Liu¹,

Lü²,

Wang³

et al. 2019

Ann. Transl. Med.

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Background: Accurate preoperative pathologic diagnosis is very important for making appropriate therapeutic decisions for patients with rectal lesions. This study aimed (I) to determine diagnostic value and safety of endoscopic forceps biopsy (EFB) and transrectal ultrasound (TRUS)-guided core needle biopsy (CNB), and (II) to analyze the risk factors for their histopathologic discrepancies, with a particular focus in identifying the indicators for re-biopsy using TRUS-guided CNB after EFB.Methods: We retrospectively reviewed the records of 102 patients who received EFB and TRUS-guided CNB before surgery. The histopathologic concordance and risk factors for underdiagnosis by EFB and TRUS-guided CNB were analyzed.Results: Compared with postoperative pathology, the histopathologic discrepancy rate of EFB and TRUS-guided CNB was 51.0% (52/102 lesions) and 8.8% (9/102 lesions), respectively. The kappa value for consistency with postoperative pathology findings was 0.420 for EFB and 0.876 for TRUS-guided CNB.The multivariate analyses and receiver operating characteristic (ROC) curve indicated that lesions thickness ≥13.5 mm [OR 1.080 (95% CI: 1.021-1.142), P=0.007] and flat/depressed shape [OR 0.206 (95% CI: 0.076-0.564), P=0.002] were significantly associated with histopathologic discrepancies in EFB.Conclusions: EFB was of limited clinical value in identifying the preoperative diagnosis of rectal lesions.Lesions thickness and flat/depressed shape at EFB were independent risk factors for pathologic discrepancies. TRUS-guided CNB may serve as a safe and effective supplement to routine EFB.

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More advanced or aggressive colorectal cancer is associated with a higher incidence of “high-grade intraepithelial neoplasia” on biopsy-based pathological examination

Cited by 12 publications

References 22 publications

Histopathologic discrepancy between endoscopic forceps biopsy and final pathology and the role of transrectal ultrasound-guided core needle biopsy

Histopathologic discrepancy between endoscopic forceps biopsy and final pathology and the role of transrectal ultrasound-guided core needle biopsy

The value of brush cytology and biopsy for the diagnosis of colorectal cancer

Diagnostic value, safety, and histopathologic discrepancy risk factors for endoscopic forceps biopsy and transrectal ultrasound-guided core needle biopsy in rectum lesions

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