HETEROGENEITY AND REMODELING OF THE MUCOSA IN THE PERITUMORAL ZONE OF COLORECTAL CANCER: A COMPREHENSIVE QUANTITATIVE MORPHOMETRIC ASSESSMENT
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Abstract
This study presents a comprehensive quantitative morphometric assessment of the colonic mucosa in the peritumoral zone (10-15 cm from the tumor margin) in patients with colorectal cancer (CRC). The analysis included 91 biopsy specimens: 41 from patients with endoscopically and histologically normal mucosa (control group) and 50 from the peritumoral zone of CRC patients.
Aim – to perform a comprehensive morphometric characterization of the mucosa in the peritumoral zone of colorectal cancer (CRC) to identify quantitative criteria of "field cancerization".
Materials and Methods. A retrospective analysis was conducted on 91 colonic mucosal biopsy specimens. Group 1 (control, n = 41) consisted of biopsies from patients with endoscopically and histologically normal mucosa. Group 2 (peritumoral zone in CRC, n = 50) included biopsies taken 10-15 cm from the macroscopic tumor margin of adenocarcinoma. Morphometric analysis was performed using an Olympus CX31 microscope and Biovision-4 software, assessing mucosal thickness, crypt density, and stroma-to-epithelium ratio.
Results. Mucosal thickness in the peritumoral zone was significantly reduced – 210.33 [185.50; 240.75] vs 245.13 [235.20; 258.45] µm in controls (p = 0.0004). The coefficient of variation of thickness increased 3.1-fold (22.40% vs 7.15%), indicating marked mucosal architectural heterogeneity. Crypt density decreased from 32.5 [30.1; 34.8] to 25.2 [21.0; 30.5] crypts/mm² (p < 0.001), while the stroma-to-epithelium ratio rose from 45.1 [42.3; 48.5] to 58.7 [51.2; 65.4] % (p < 0.001).
Conclusion. The identified morphometric alterations provide evidence of a «field of cancerization» in the peritumoral zone of CRC and may serve as an additional diagnostic criterion for planning the extent of surgical resection.
Keywords
Author Biographies
Oleg Ivanovich Bondarev,
MD, PhD, head of the research laboratory for pathological anatomy
Sergey Nikolaevich Filimonov,
doctor of medical sciences, professor, head of the department of human ecology, public health and healthcare; professor of the therapy departmentPavel Alekseevich Azarov,
candidate of medical sciences, assistant of the department of pathological anatomy and forensic medicineArnold Michailovich Surkov,
assistant of the department of pathological anatomy and forensic medicineAleksey Grigoryevich Korotkevitch,
doctor of medical sciences, professor, head of the department of surgery, urology, endoscopy, and pediatric surgeryArticle Details
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The authors declare that they have no apparent or potential conflicts of interest related to the publication of this article.
This work is licensed under a Creative Commons Attribution 4.0 License.
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