Micropapillary component in colorectal carcinoma is associated with lymph node metastasis in T1 and T2 Stages and decreased survival time in TNM stages I and II.
Colorectal carcinoma with a micropapillary component (MP) is an exceptionally aggressive variant, but has never been investigated in terms of survival analysis. Thirty colorectal carcinomas with a MP were identified from a series of 221 colorectal carcinomas. Carcinomas with and without a MP were compared in terms of histologic and immunohistochemical markers. Colorectal carcinoma with a MP seemed to have a lower differentiation status, increased tumor budding, more frequent lymphovascular and perineural invasion, more frequent lymph node metastasis, higher tumor node metastasis (TNM) stage, and less nuclear beta-catenin staining (P<0.05). Further analysis revealed that the presence of a MP predicted more frequent lymph node metastasis in T1 and T2 stages but not in T3 and T4 stages. Five-year survival rates for patients with a MP and those without were 50% and 73%, respectively. Furthermore, in TNM stages I and II, but not in TNM stages III and IV, a MP was an unfavorable prognostic variable. A MP was demonstrated to be an independent unfavorable prognostic indicator in TNM stages I and II by the multivariate Cox proportional hazard model. Colorectal carcinoma with a MP should be distinguished from colorectal carcinoma of conventional histologic type.
Xu
Fangying
F
Department of Pathology, School of Medicine, Zhejiang University, China.
Xu
Jinping
J
Lou
Zhongming
Z
Di
Meijuan
M
Wang
Fenjuan
F
Hu
Hu
H
Lai
Maode
M
D000230:Adenocarcinoma / Q000737:chemistry / Q000401:mortality / Q000556:secondary*; D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis; D002291:Carcinoma, Papillary / Q000737:chemistry / Q000401:mortality / Q000556:secondary*; D002681:China / Q000453:epidemiology; D015179:Colorectal Neoplasms / Q000737:chemistry / Q000401:mortality / Q000473:pathology*; D005260:Female; D006801:Humans; D019394:Ki-67 Antigen / Q000032:analysis; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009378:Neoplasms, Multiple Primary / Q000401:mortality / Q000556:secondary*; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000032:analysis; D015996:Survival Rate; D013940:Thymidylate Synthase / Q000032:analysis; D016159:Tumor Suppressor Protein p53 / Q000032:analysis; D051176:beta Catenin / Q000032:analysis
D014408:Biomarkers, Tumor; C495270:CTNNB1 protein, human; D019394:Ki-67 Antigen; D019253:Proto-Oncogene Proteins c-bcl-2; D016159:Tumor Suppressor Protein p53; D051176:beta Catenin; D013940:Thymidylate Synthase