Authors: Hiroo Wada Manabu Shiozawa Nobuhiro Sugano Soichiro Morinaga Yasushi Rino Munetaka Masuda Makoto Akaike Yohei Miyagi
Publish Date: 2012/11/01
Volume: 18, Issue: 6, Pages: 1025-1031
Abstract
The management of T1 colorectal cancer after local resection is controversial Regional lymph node metastasis often occurs requiring subsequent colonic resection The aim of this study was to reevaluate the risk factors of nodal metastasis of T1 colorectal cancer especially to examine lymphatic vessel invasion in serially prepared hematoxylin and eosin sections and D240 immunostained sections to determine which is a better indicator of lymph node metastasis of T1 colorectal cancerThe study investigated 120 patients who underwent bowel resection and were histologically diagnosed to have T1 colorectal cancer in Kanagawa Cancer Center Hospital from 1995 to 2005 Serially prepared paraffin sections were stained with hematoxylin and eosin or immunostained with D240 antibody or von Willebrand factor and reevaluated for lymphatic vessel invasion and other risk factors including venous invasion histological grade depth of submucosal invasion and buddingLymphatic invasion diagnosed with either hematoxylin and eosin staining p = 0022 or D240 immunostaining p = 0001 and budding p = 0013 were significant risk factors for lymph node metastasis in the univariate analysis Venous involvement histological grade or depth of submucosal invasion was not significant The multivariate logistic regression analysis for the three risk factors found lymphatic invasion diagnosed with D240 as an independent risk factor odds ratio 6048 p = 0018 CI 1360–2689 The sensitivity specificity positive predictive value and negative predictive value were 58 88 35 and 95 respectively
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