{"title":"Endoscopic Scoring System for T2 Invasion in Colorectal Cancer","authors":"Akinori Sasaki , Ryoko Shimizuguchi , Akinari Takao , Satomi Shibata , Souichiro Natsume , Shin-ichiro Horiguchi , Daisuke Nakano , Tatsuro Yamaguchi , Koichi Koizumi","doi":"10.1016/j.tige.2021.11.005","DOIUrl":null,"url":null,"abstract":"<div><h3>Background and Aims</h3><p>The depth of tumor invasion in colorectal cancer (CRC), especially T1b or T2, is crucial in treatment decision-making. However, their differences are not well-characterized. Thus, this study aimed to investigate the predictive endoscopic findings in tumor invasion of CRC.</p></div><div><h3>Methods</h3><p>Data from patients with T1b or T2 CRCs resected endoscopically or surgically were reviewed retrospectively. The patients were divided into 2 groups: T1b (n = 298) and T2 (n = 267) tumor invasion. A scoring system was established based on the endoscopic findings in each group, and the accuracy of the system was assessed using a receiver-operating-characteristic (ROC) curve analysis.</p></div><div><h3>Results</h3><p>T2 invasion was predicted by tumor size, irregular bottom of depression, existence of depression, expansion appearance, convergency of folds, and erosion or white coat. The risk scoring system was developed using the regression coefficient values of the above variables. The area under the ROC curve was 0.894 (95% confidence interval, 0.868-0921). Cases with a score ≥4 had a high risk of T2 (sensitivity, 84.5%; specificity, 78.9%).</p></div><div><h3>Conclusion</h3><p>Our scoring system was useful for the diagnosis of T1b and T2, and a score ≥4 could predict T2 invasion. Additional studies are warranted to confirm these results before our scoring system can be applied clinically.</p></div>","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":null,"pages":null},"PeriodicalIF":1.2000,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590030721000866/pdfft?md5=7bcf3d9f52bafd243f7c0bd19537eed0&pid=1-s2.0-S2590030721000866-main.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Techniques and Innovations in Gastrointestinal Endoscopy","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2590030721000866","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background and Aims
The depth of tumor invasion in colorectal cancer (CRC), especially T1b or T2, is crucial in treatment decision-making. However, their differences are not well-characterized. Thus, this study aimed to investigate the predictive endoscopic findings in tumor invasion of CRC.
Methods
Data from patients with T1b or T2 CRCs resected endoscopically or surgically were reviewed retrospectively. The patients were divided into 2 groups: T1b (n = 298) and T2 (n = 267) tumor invasion. A scoring system was established based on the endoscopic findings in each group, and the accuracy of the system was assessed using a receiver-operating-characteristic (ROC) curve analysis.
Results
T2 invasion was predicted by tumor size, irregular bottom of depression, existence of depression, expansion appearance, convergency of folds, and erosion or white coat. The risk scoring system was developed using the regression coefficient values of the above variables. The area under the ROC curve was 0.894 (95% confidence interval, 0.868-0921). Cases with a score ≥4 had a high risk of T2 (sensitivity, 84.5%; specificity, 78.9%).
Conclusion
Our scoring system was useful for the diagnosis of T1b and T2, and a score ≥4 could predict T2 invasion. Additional studies are warranted to confirm these results before our scoring system can be applied clinically.