Factors that influence bleeding in superficial-type colorectal tumors: study of endoscopic and histologic correlates.

To clarify the mechanisms responsible for superficial-type colorectal tumor (STT) bleeding, 74 STTs were studied to determine whether their size, shape, surface area features, colorectal site, and level of invasion were correlated with bleeding. The bleeding rate, the proportion of specimens from patients with positive fecal occult blood test (FOBT) results relative to the total number of specimens in each morphological group and probability of an STT being an invasive submucosal carcinoma were positively correlated with tumor size, and bleeding was more common in submucosal than in intramucosal lesions. Logistic regression analysis indicated that the level of submucosal invasion had a significant influence on bleeding. It was also found that the length of erosion on the surface of STTs was significantly greater in bleeding tumors, and that the potential for invasion into the submucosa increased with the area of erosion.