1. Histological factors predicting loco-regional lymph node metastasis in early invasive colorectal adenocarcinoma pT1
- Author
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Carlos Fernández-Martos, Alfonso García Fadrique, Rafael Estevan, Isidro Machado, Fernando Martínez de Juan, Julia Cruz, Jorge Campos, Miriam Valera-Alberni, Fernanda Maia de Alcantara, José Antonio López-Guerrero, Carmen Martínez Lapiedra, and Ricardo Yaya
- Subjects
Adenoma ,Pathology ,medicine.medical_specialty ,Multivariate analysis ,Colorectal cancer ,Perineural invasion ,Adenocarcinoma ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Submucosa ,medicine ,Humans ,Neoplasm Invasiveness ,Lymph node ,Univariate analysis ,business.industry ,Prognosis ,medicine.disease ,medicine.anatomical_structure ,Lymphatic Metastasis ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,Lymph Nodes ,Colorectal Neoplasms ,business - Abstract
Introduction Endoscopic resection is the common treatment in pT1 colorectal adenocarcinoma whenever possible. The presence of adverse histological factors requires subsequent lymph node evaluation. Materials and methods We selected 29 colorectal pT1 adenocarcinoma including endoscopic polypectomies and the corresponding surgical specimens. All histologic parameters associated with N+ were evaluated by 2 pathologists, including: tumour differentiation grade, depth of invasion in the submucosa, angiolymphatic invasion (ALI), perineural invasion, chronic inflammation, tumour budding, poorly differentiated cluster, pre-existing adenoma, tumour border, and endoscopic resection margin. Univariate and multivariate logistic regression analysis was performed to assess the individual capacity of each variable to predict N+. Results In the univariate analysis, rectal tumour localization, ALI and poorly differentiated cluster were significantly associated with N+. Among the significant parameters, ALI had the highest area under the ROC curve (0.875). Multivariate analysis showed no independent variables associated with N+. Conclusions We confirm that ALI and the presence of poorly differentiated cluster are frequently associated with N+ in early colorectal cancer. Consequently, these parameters should be routinely evaluated by pathologists.
- Published
- 2016