A new practical classification of desmoplastic reaction in endoscopic forceps biopsy of colorectal cancer
Haiyan Jing1, Liang Shang2, Shulei Zhao3, Zhigang Yao1, Beibei Lv1 and Xiaolong Zhu4
1Department of Pathology, 2Department of Gastrointestinal Surgery, 3Department of Endoscopy and 4Department of Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
Corresponding Author: Xiaolong Zhu, Department of Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China. e-mail: xiaolongzhuxw@163.com
Summary. Background. The histopathological discrepancy between endoscopic forceps biopsy (EFB) and post-resection specimens is considered a practical clinical problem. This retrospective study aimed to determine the current diagnostic concordance between the EFB and surgical specimens of colorectal cancer (CRC) and then investigated the useful factors in EFB diagnosis.
Methods. We used the representative pathological data of 2188 CRCs. The comparison of histopathological discrepancy between EFB and the related surgical specimens was performed. Furthermore, 418 biopsy specimen slides in our hospital were reviewed to determine the classification of intratumor desmoplastic reaction (DR).
Results. Among the 2188 patients, the positive sensitivity of EFB for adenocarcinoma was 82.7%. The discrepancy rate between the EFB and surgical specimens was 10.8-40.0% corresponding to different T stages. On the basis of DR classification, 32, 131, and 255 tumors were categorized as little, moderate and extensive, respectively. The correlation between DR classification and tumor invasion based on T stage was significant (Spearman's rho= 0.112; p<0.05). The extensive DR provided better estimates for advanced tumors than the little and moderate DR (χ2= 3.977, p=0.046). Besides DR, factors including deeper cutting the slides and histological types were significantly associated with "adenocarcinoma" diagnosis in EFB of CRCs (p<0.05).
Conclusion. To the best of our knowledge, this is the first time that a DR classification specifically for EFB specimens was proposed. It might contribute to improve the accuracy of biopsy-based diagnosis of CRC. Histol Histopathol 36, 765-773 (2021)
Key words: Desmoplastic reaction, Colorectal cancer, Endoscopic forceps biopsy
DOI: 10.14670/HH-18-353
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©The Author(s) 2021. Open Access. This article is licensed under a Creative Commons CC-BY International License. |
