title: Pathological predictors for lymph node metastasis in T1 colorectal cancer.
abstract: OBJECTIVE
  To clarify pathological predictor for lymph node metastasis in T1 colorectal cancer.
  
  
  METHODS
  One hundred and sixty-four patients who underwent surgery for single T1 colorectal cancer were reviewed. The pathological differentiations of non-well differentiation, invasion depth (> or =2 000 microm), lymphatic channel involvement, venous invasion, and tumor budding were selected as candidate predictors. Tumor budding was estimated according to the definition proposed by Ueno et al. (Gastroenterology 2004; 127:385-394). The lymph node status was set for the endpoint. Logistic regression model was applied to analyze the predictors.
  
  
  RESULTS
  Lymph node involvement was observed in 9.8%. The positive rates were 13.4% for the pathological differentiations of non-well differentiation, 51.8% for invasion depth (> or =2 000 microm), 6.1% for lymphatic channel involvement, 8.5% for venous invasion, and 14.6% for tumor budding. The pathological differentiations of non-well differentiation (P < 0.001) and tumor budding (P = 0.002) were significantly associated with lymph node metastasis in multivariate analysis. When either two significant factors was adopted for the prediction of the lymph node metastasis, the sensitivity, specificity, positive predictive value, and negative predictive value were 94%, 82%, 36%, and 99%, respectively.
  
  
  CONCLUSIONS
  The pathological differentiations of non-well differentiation and tumor budding are useful predictors for lymph node metastasis in T1 colorectal cancer.
authors.affiliation: Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Yamauchi
authors.forename: Kazutomo
authors.initials: K
authors.lastname: Togashi
authors.forename: Yutaka J
authors.initials: YJ
authors.lastname: Kawamura
authors.forename: Hisanaga
authors.initials: H
authors.lastname: Horie
authors.forename: Junichi
authors.initials: J
authors.lastname: Sasaki
authors.forename: Shingo
authors.initials: S
authors.lastname: Tsujinaka
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Yasuda
authors.forename: Fumio
authors.initials: F
authors.lastname: Konishi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D016015:Logistic Models; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity