Lifting versus Non-Lifting Sign for Prediction of Depth of Invasion of Early Colorectal Cancer

Abstract

Submucosal (sm) invasion by colorectal cancer can be classified as slight (depth of invasion < 1000 µm) or massive (depth of invasion > 1000 µm). Lesions classified as sm1 and sm2 are elevated in response to sm injection, whereas lesions classified as sm3 are not elevated. When sm invasion is slight, there is negligible risk of lymphatic metastasis, and cure can be achieved by endoscopic resection alone. However, when sm invasion is massive, the risk of lymphatic metastasis is substantial, increasing with the depth of invasion. The authors previously reported that a test based on lifting indicating sm1 or sm2 lesions would have a sensitivity of 83% and a specificity of 100%, whereas a test based on nonlifting indicating sm3 lesions would have a sensitivity of 100% and a specificity of 83%. Here the evaluation of these two types of tumor, classified as lifting and nonlifting lesions, is demonstrated. This article is part of an expert video encyclopedia.