Retrospective Cohort Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. May 14, 2023; 29(18): 2836-2849
Published online May 14, 2023. doi: 10.3748/wjg.v29.i18.2836
Endoscopic and pathological characteristics of de novo colorectal cancer: Retrospective cohort study
Shi-Yang Li, Mei-Qi Yang, Yi-Ming Liu, Ming-Jun Sun, Hui-Jing Zhang
Shi-Yang Li, Mei-Qi Yang, Yi-Ming Liu, Ming-Jun Sun, Hui-Jing Zhang, Department of Endoscopy, The First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
Author contributions: Zhang HJ had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis; Zhang HJ, Li SY, and Yang MQ were responsible for protocol/project development; Li SY, Yang MQ, and Zhang HJ performed data analysis; Li SY, Yang MQ, Liu YM, and Sun MJ performed data collection or management; Yang MQ and Zhang HJ were responsible for manuscript writing/editing; Li SY and Yang MQ, these two authors, contributed equally to this work.
Supported by Natural Science Foundation of Liaoning Province, China, No. 2022-YGJC-71.
Institutional review board statement: The study was reviewed and approved by the Research Ethics Committee of the First Affiliated Hospital of China Medical University Institutional Review Board, No. [2021]2021-68-2.
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Participants gave informed consent for data sharing.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Hui-Jing Zhang, MD, Professor, Department of Endoscopy, The First Affiliated Hospital of China Medical University, No. 155 Nanjing North Street, Heping District, Shenyang 110001, Liaoning Province, China.
Received: March 28, 2023
Peer-review started: March 28, 2023
First decision: April 10, 2023
Revised: April 14, 2023
Accepted: April 19, 2023
Article in press: April 19, 2023
Published online: May 14, 2023
Research background

The small colorectal small tumors usually be ignored during colonoscopy. However, many depressed or flat lesions have substantial invasion and metastasis. De novo colorectal cancer (CRC) is one type of small tumor related to poor prognosis. And some endoscopists could not distinguish de novo CRC during the examination.

Research motivation

Some small lesions were cut off directly in the examination without computed tomography imaging and endoscopic ultrasound. This may lead to mistreatment because endoscopists often ignore the judgment of invasion depth. The de novo CRC may have a deep invasion layer.

Research objectives

This study aimed to comprehensively review de novo CRCs and provide a reference atlas for future studies and analyze the features of de novo CRCs to distinguish them from non-neoplastic polyps.

Research methods

This study collected clinical and pathological information on de novo patients and stained E-cadherin and vimentin by immunohistochemistry. Based on this information, we analyzed the characteristic of de novo CRC and the relative correlation between different indicators.

Research results

This study highlights that de novo CRCs have special endoscopic and pathological features that distinguish them from traditional adenocarcinomas. It is also the first study paying attention to chicken skin mucosa invasive depth measurement. More importantly, this study summarized several factors relevant to invasion depth and provide tremendous help in clinical practice to increase diagnostic ability.

Research conclusions

This first study pointed out the relationship between de novo CRC and epithelial-mesenchymal transition related genes. And it is the first study put forward that chicken skin mucosa indicates the depth of invasion.

Research perspectives

We will further study the molecular biological difference between de novo CRC and carcinoma in adenoma CRC to discover the mechanism of invasion and metastasis of de novo CRCs.