A new practical classification of desmoplastic reaction in endoscopic forceps biopsy of colorectal cancer.
2021
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.
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