Factors associated with risk for submucosal invasion of colon lesions initially diagnosed severe dysplasia by forceps biopsies

Background and Aims: Biopsy results are very difficult to estimate the depth of the lesion and the other endoscopic factors are very important to predict the submucosal invasion . The aim of this study was to evalue the risk factors for submucosal invasion of colon lesions initially showed severe dysplasia by forceps biopsies.
Patients and Methods:Two hundred and twenty two colon lesions initially diagnosed as severe dysplasia by forceps biopsies from 2010 to 2013 in our hospital were included in this retrospective analysis.All lesions underwent endoscopic resection or surgical therapy. The location,size,gross morphology of each lesion and whether or not the lesion had fullness,depressed area,converging fold,lifting sign, disappeared microstructure were evalued . Logistic regression analysis was used to analyzed the risk factors associated with submucosal invasion of the lesion.
Results :Fourty four lesions(19.8%) were diagnosed submucosal invasion by endoscopic resection or surgical therapy.Multivariate analysis revealed that the lesion with depressed area (OR10.576 [95% CI 2.669-41.905]), with fullness (OR10.341 [95% CI 3.016-35.461]),and lesion with disappeared microstructure (OR16.777 [95% CI 3.590-78.391])were significant risk factors.
Conclusions:Surgical therapy may be recommended if colon lesion with severe dysplasia diagnosed by biopsies had depressed area ,fullness or disappeared microstructure.For lesions without above risk factors,endoscopic treatment may be recommended.