Department of Hospital Pathology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 137-701, South Korea.
Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 137-701, South Korea.
World J Gastroenterol. 2017 Aug 28;23(32):5936-5944. doi: 10.3748/wjg.v23.i32.5936.
To evaluate a novel grading system to predict lymph node metastasis (LNM) in patients with submucosal invasive colorectal carcinoma (SICRC).
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.
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).
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.
评估一种新的分级系统，以预测黏膜下浸润性结直肠癌（SICRC）患者的淋巴结转移（LNM）。
我们分析了 2000 年至 2015 年间在首尔圣玛丽医院接受根治性手术的 252 例 SICRC 患者的 LNM 与各种临床病理特征之间的关系。
31 例（12.3%）发生 LNM。黏膜下浸润深度和宽度、淋巴管浸润、肿瘤芽生以及低分化簇（PDC）的存在与 LNM 的发生率显著相关。使用多变量分析，计算了受试者工作特征曲线，并使用曲线下面积（AUC）比较了不同参数识别 LNM 风险的能力。预测 LNM 的最有力的临床病理参数是淋巴管浸润（差异 AUC = 0.204），其次是肿瘤芽生的存在与否（差异 AUC = 0.190）、PDC 的存在（差异 AUC = 0.172）以及 Ueno 方法分级的肿瘤芽生（差异 AUC = 0.128）。
我们的结果表明，肿瘤芽生和黏膜下浸润深度乘以宽度的测量值可为 SICRC 患者提供重要信息。
