Patient selection: pedunculated T1 colorectal carcinoma
Rate of metastases: 5.2%
Parameters:
(1) Haggitt level, from 1 to 4 (Haggitt level 4 is invasion beyond the stalk but above the muscularis propria, or invasion into the stalk with a positive resection margin)
(2) tumor budding (cancer cell nests with 1-4 cells infiltrating the interstitium at the invasive margin)
(3) poorly differentiated clusters (PDC; cancer cell clusters with >= 5 cells without gland-like structure in the stoma)
(4) lymphovascular invasion
(5) status of muscularis mucosae (Type A is shattered but aligned; Type B is incompletely or completely disrupted)
|
Parameter
|
Finding
|
Points
|
|
Haggitt level 4
|
no
|
0
|
|
|
yes
|
1.45
|
|
tumor budding
|
negative
|
0
|
|
|
positive
|
-0.66
|
|
poorly differentiated clusters
|
negative
|
0
|
|
|
positive
|
1.30
|
|
lymphovascular invasion
|
negative
|
0
|
|
|
positive
|
1.28
|
|
muscularis mucosae
|
type A
|
0
|
|
|
type B
|
2.31
|
value of X =
= SUM(points for all 5 parameters) - 6.13
probability of metastases =
= 1 / (1 + EXP((-1) * X))
Performance:
• The area under the ROC curve is 0.82.
