title: Evaluation of tumor cell dissociation as a predictive marker of lymph node metastasis in submucosal invasive colorectal carcinoma.
abstract: OBJECTIVE
  Tumor cell dissociation-the histologic finding of small solid carcinoma cell clusters and groups of dissociated dedifferentiated carcinoma cells at the invasive front-is related to tumor metastasis and patient prognosis. However, few previous reports have examined tumor cell dissociation in submucosal invasive colorectal carcinoma. We investigated the relation between tumor cell dissociation and lymph node metastasis in submucosal invasive colorectal carcinoma. We also examined immunohistochemical expression of E-cadherin and beta-catenin in submucosal invasive colorectal carcinoma.
  
  
  METHODS
  Submucosal invasive colorectal carcinoma tissue samples from 20 patients with lymph node metastasis and 100 patients without lymph node metastasis were evaluated. Sections stained with hematoxylin and eosin were evaluated for tumor cell dissociation. Immunohistochemistry was used to determine the expression and cellular distribution of E-cadherin and beta-catenin.
  
  
  RESULTS
  Tumor cell dissociation was more frequently identified in submucosal invasive colorectal carcinoma cases with lymph node metastasis than in those without lymph node metastasis (P = 0.0001). Decreased membranous expression of E-cadherin occurred more frequently in submucosal invasive colorectal carcinoma cases with lymph node metastasis than in those without lymph node metastasis (P = 0.025). Nuclear expression of beta-catenin tended to be present in submucosal invasive colorectal carcinoma cases with lymph node metastasis (P = 0.063). Decreased membranous expression of E-cadherin occurred more frequently in submucosal invasive colorectal carcinoma cases with tumor cell dissociation than in those without tumor cell dissociation (P = 0.0023).
  
  
  CONCLUSIONS
  Our results suggest that there is a relation between tumor cell dissociation and lymph node metastasis in submucosal invasive colorectal carcinoma. Tumor cell dissociation formation might be related to abnormal expression patterns of E-cadherin and beta-catenin in submucosal invasive colorectal carcinoma. Tumor cell dissociation and decreased membranous expression of E-cadherin would be important predictive markers for lymph node metastasis in submucosal invasive colorectal carcinoma.
authors.affiliation: Department of Surgical and Molecular Pathology, Dokkyo University School of Medicine, Tochigi 321-0293, Japan.
authors.forename: Hiroshige
authors.initials: H
authors.lastname: Hori
authors.forename: Takahiro
authors.initials: T
authors.lastname: Fujimori
authors.forename: Shigehiko
authors.initials: S
authors.lastname: Fujii
authors.forename: Kazuhito
authors.initials: K
authors.lastname: Ichikawa
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Ohkura
authors.forename: Shigeki
authors.initials: S
authors.lastname: Tomita
authors.forename: Yuko
authors.initials: Y
authors.lastname: Ono
authors.forename: Johji
authors.initials: J
authors.lastname: Imura
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Kuroda
mesh_terms: D015820:Cadherins / Q000378:metabolism*; D016009:Chi-Square Distribution; D015179:Colorectal Neoplasms / Q000378:metabolism* / Q000473:pathology* / Q000601:surgery; D003598:Cytoskeletal Proteins / Q000378:metabolism*; D016099:Endoscopy, Gastrointestinal; D006801:Humans; D007124:Immunoenzyme Techniques; D007413:Intestinal Mucosa / Q000378:metabolism / Q000473:pathology; D008207:Lymphatic Metastasis; D009361:Neoplasm Invasiveness; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D013194:Staining and Labeling; D015534:Trans-Activators / Q000378:metabolism*; D051176:beta Catenin
chemical_list: C495270:CTNNB1 protein, human; D015820:Cadherins; D003598:Cytoskeletal Proteins; D015534:Trans-Activators; D051176:beta Catenin