Cellular and Structural Atypia of the Early Colorectal Cancers

Abstract

Abstract:Cellular and structural gland atypia in lesions of early colorectal cancer removed by endoscopic polypectomy in 101 patients were histopathologically studied. The following results were observed. Cellular atypia was frequently found in lesions with a high rate of nuclear polarity loss and multiple nuclear mitoses (99. 0%). The most frequent findings in the glands with structural atypia was intraglandular glands and crowding of neoplastic glands (85. 1%). Most of the appearances of the cellular and structural atypias showed no marked relationship with the sizes of the lesions, depth of invasion and association of adenoma components. Early cancer had both cellular and structural atypia in 95% of the patients and could be diagnosed by conventional histopathological criteria. However five patients with early cancer showed no structural atypia and were diagnosed as having cellular atypia. These cancers were early intramucosal cancer and four lesions were associated with adenoma components 20 mm or less in size. The loss of nuclear polarity and nuclear pleomorphism may be considered more important than nuclear stratification and mitoses in the diagnosis of early cancer.