Nishida Tsukasa, Egashira Yutaro, Akutagawa Hiroshi, Fujii Mototsugu, Uchiyama Kazuhisa, Shibayama Yuro, Hirose Yoshinobu
1Department of Pathology, Osaka Medical College, Osaka, Japan 2Department of General and Gastroenterological Surgery, Osaka Medical College, Osaka, Japan.
Dis Colon Rectum. 2014 Aug;57(8):905-15. doi: 10.1097/DCR.0000000000000168.
The appropriateness of endoscopic resection in patients with T1 colorectal carcinomas is unclear. Highly precise predictors of lymph node metastasis are required to optimize the outcomes of treatments for T1 colorectal carcinomas.
The purpose of this work was to identify predictors of lymph node metastasis by examining the clinicopathologic significance of immunophenotypes found in T1 colorectal carcinomas.
This was a retrospective study.
The study was conducted at a university hospital.
Included were 265 patients with T1 colorectal carcinoma who underwent radical surgery.
Patients with T1 colorectal carcinoma were managed.
Immunophenotypes were associated with various clinicopathologic parameters, and CD10 expression was strongly associated with lymph node metastasis.
The levels of MUC2, MUC5AC, and CD10 expression were individually significantly associated with tumor location, growth pattern, histologic type, invasive potential, and metastatic potential. The incidence of lymph node metastasis was significantly associated with each of the 5 following parameters: depth of submucosal invasion (p = 0.005), tumor budding (p < 0.001), lymphatic invasion (p < 0.001), MUC2 expression (p = 0.006), and CD10 expression (p < 0.001). Multivariate analysis showed that CD10 expression (OR, 9.2 [95% CI, 2.5-39.8]; p = 0.001) and lymphatic invasion (OR, 6.3 [95% CI, 2.5-17.7]; p < 0.001) were independently associated with lymph node metastasis.
This study was limited by its small sample size, intraobserver variation attributed to immunohistochemical staining, and potential selection bias because surgically resected specimens were collected instead of endoscopically resected specimens.
We suggest that CD10 expression is closely associated with lymph node metastasis in T1 colorectal carcinoma.
T1期结直肠癌患者内镜切除的适宜性尚不清楚。需要高度精确的淋巴结转移预测指标来优化T1期结直肠癌的治疗效果。
本研究旨在通过研究T1期结直肠癌免疫表型的临床病理意义来确定淋巴结转移的预测指标。
这是一项回顾性研究。
该研究在一家大学医院进行。
纳入265例行根治性手术的T1期结直肠癌患者。
对T1期结直肠癌患者进行治疗。
免疫表型与各种临床病理参数相关，CD10表达与淋巴结转移密切相关。
MUC2、MUC5AC和CD10的表达水平分别与肿瘤位置、生长方式、组织学类型、浸润潜能和转移潜能显著相关。淋巴结转移发生率与以下5个参数均显著相关：黏膜下浸润深度（p = 0.005）、肿瘤芽生（p < 0.001）、淋巴管浸润（p < 0.001）、MUC2表达（p = 0.006）和CD10表达（p < 0.001）。多因素分析显示，CD10表达（OR，9.2 [95% CI，2.5 - 39.8]；p = 0.001）和淋巴管浸润（OR，6.3 [95% CI，2.5 - 17.7]；p < 0.001）与淋巴结转移独立相关。
本研究受样本量小、免疫组化染色导致的观察者内差异以及因收集手术切除标本而非内镜切除标本而存在的潜在选择偏倚的限制。
我们认为CD10表达与T1期结直肠癌的淋巴结转移密切相关。
