Correct understanding of pathological evaluation and prognostic value of the invasion depth of early colorectal cancer (pT1)
10.3760/cma.j.cn112151-20250723-00500
- VernacularTitle:早期结直肠癌（pT1）浸润深度病理评估及预后价值的正确认识
- Author:
Yunfan WANG
1
;
Weicheng XUE
Author Information
1. 北京大学首钢医院病理科，北京 100144
- Publication Type:Journal Article
- Keywords:
Colorectal neoplasms;
Prognosis;
Tumor-Infiltrating;
Early diagnosis
- From:
Chinese Journal of Pathology
2025;54(11):1117-1123
- CountryChina
- Language:Chinese
-
Abstract:
Colorectal cancer (CRC) is one of the most malignant tumors with high morbidity and mortality worldwide. Early diagnosis and accurate pathological evaluation are of great significance for improving patient prognosis. Endoscopic resection is the main treatment for early CRC. Pathological parameters-such as margin status, lymphatic vascular invasion (LVI), tumor grade, depth of submucosal invasion and tumor budding are the key to determine whether curative resection is achieved. At present, the measurement method of submucosal invasion depth of pT1 CRC is controversial. Submucosal invasion depth measurement adopts different measurement methods for pedunculated and sessile lesions, mainly including measurement from the surface of the lesion or the lower edge of the mucosal muscle layer. Especially for sessile lesions, due to different observers different understandings of the position of the mucosal muscle layer that can be identified or evaluated in the guidelines, observers may apply different criteria to evaluate the integrity of the mucosal muscle layer. In recent years, more and more evidence has shown that the association between the depth of submucosal invasion and the risk of lymph node metastasis may be overestimated, while other pathological parameters (such as LVI, high-grade tumor budding, and poorly differentiated components) have equal or more important significance in prognostic stratification. Therefore, the current measurement of the depth of submucosal invasion of pT1 CRC and its prognostic value are facing challenges, which deserve our attention and further exploration.
