Histological Risk Factors for Lymph Node Metastasis in pT1 Colorectal Cancer:Does Submucosal Invasion Depth Really Matter?  

作　　者：Bing YUE Mei JIA Rui XU Guang-yong CHEN Mu-lan JIN 

机构地区：[1]Department of Pathology,Beijing Friendship Hospital,Capital Medical University,Beijing,100050,China [2]Department of Pathology,Beijing Chaoyang Hospital,Capital Medical University,Beijing,100015,China

出　　处：《Current Medical Science》2024年第5期1026-1035,共10页当代医学科学（英文）

基　　金：supported by a grant from the National Key Research and Development Program of China(No.2023YFC2507406).

摘　　要：Objective After endoscopic resection of colorectal cancer with submucosal invasion(pT1 CRC),additional surgical treatment is recommended if deep submucosal invasion(DSI)is present.This study aimed to further elucidate the risk factors for lymph node metastasis(LNM)in patients with pT1 CRC,especially the effect of DSI on LNM.Methods Patients with pT1 CRC who underwent lymph node dissection were selected.The Chi-square test and multivariate logistic regression were used to analyze the relationship between clinicopathological characteristics and LNM.The submucosal invasion depth(SID)was measured via 4 methods and analyzed with 3 cut-off values.Results Twenty-eight of the 239 patients presented with LNM(11.7%),and the independent risk factors for LNM included high histological grade(P=0.003),lymphovascular invasion(LVI)(P=0.004),intermediate to high budding(Bd 2/3)(P=0.008),and cancer gland rupture(CGR)(P=0.008).Moreover,the SID,width of submucosal invasion(WSI),and area of submucosal invasion(ASI)were not significantly different.When one,two,three or more risk factors were identified,the LNM rates were 1.1%(1/95),12.5%(7/56),and 48.8%(20/41),respectively.Conclusion Indicators such as the SID,WSI,and ASI are not risk factors for LNM and are subjective in their measurement,which renders them relatively inconvenient to apply in clinical practice.In contrast,histological grade,LVI,tumor budding and CGR are relatively straightforward to identify and have been demonstrated to be statistically significant.It would be prudent to focus on these histological factors rather than subjective measurements.

关 键 词：lymph node metastasis early colorectal cancer lymph node dissection submucosal invasion depth tumor budding cancer gland rupture 

分 类 号：R735.35[医药卫生—肿瘤]