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Observational Study
. 2017 Aug 28;23(32):5936-5944.
doi: 10.3748/wjg.v23.i32.5936.

Novel predictors for lymph node metastasis in submucosal invasive colorectal carcinoma

Kwangil Yim  1 , Daeyoun David Won  2 , In Kyu Lee  2 , Seong-Taek Oh  3 , Eun Sun Jung  1 , Sung Hak Lee  4
Affiliations
Observational Study

Novel predictors for lymph node metastasis in submucosal invasive colorectal carcinoma

Kwangil Yim et al. World J Gastroenterol. .

Abstract

Aim: To evaluate a novel grading system to predict lymph node metastasis (LNM) in patients with submucosal invasive colorectal carcinoma (SICRC).

Methods: We analyzed the associations between LNM and various clinicopathological features in 252 patients with SICRC who had undergone radical surgery at the Seoul Saint Mary's hospital between 2000 and 2015.

Results: LNM was observed in 31 patients (12.3%). The depth and width of the submucosal invasion, lymphatic invasion, tumor budding, and the presence of poorly differentiated clusters (PDCs) were significantly associated with the incidence of LNM. Using multivariate analysis, the receiver operating characteristic curvewas calculated and the area under curve (AUC) was used to compare the ability of the different parameters to identify the risk of LNM. The most powerful clinicopathological parameter for predicting LNM was lymphatic invasion (difference AUC = 0.204), followed by the presence or absence of tumor budding (difference AUC = 0.190), presence of PDCs (difference AUC = 0.172) and tumor budding graded by the Ueno method (difference AUC = 0.128).

Conclusion: Our results indicate that the tumor budding and the depth multiplied by the width measurements of submucosal invasion can provide important information for patients with SICRC.

Keywords: Colorectal cancer; Lymph node; Metastasis; Neoplasm invasion.

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Conflict of interest statement

Conflict-of-interest statement: The authors do not have any conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Representative histopathological micrograph of tumor budding (magnification × 400). Hematoxylin and eosin staining of a tumor section showing tumor budding (black arrows) at the invasive front.
Figure 2
Figure 2
Representative histopathological micrograph of poorly differentiated clusters (magnification × 400). Hematoxylin and eosin stain of tumor section showing cancer cell clusters of ≥ 5 carcinoma cells lacking a glandular formation (poorly differentiated clusters, black arrows).
Figure 3
Figure 3
Comparison of receiver operating characteristic curves by multivariate logistic regression tests. Desmoplaisa and tumor type were used as compounding factors.
See this image and copyright information in PMC

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