title: Objective criteria for crohn-like lymphoid reaction in colorectal cancer.
abstract: We aimed to determine semiquantitative evaluation criteria for Crohn-like lymphoid reaction (CLR). We reviewed 1,032 patients with colorectal cancer and evaluated CLR by counting all peritumoral lymphoid aggregates (LAs) and by measuring the maximum diameter of the largest LA. The maximum diameter of the largest LA, rather than the number, had a significant impact on survival. Active CLR determined by the 1-mm rule was significantly associated with MLH1/MSH2 immunohistochemical staining deficiency. The group with LAs 1 mm or larger had lower recurrence (P = .0008) and a higher survival rate (P < .0001) than that without LAs 1 mm or larger. These results were similarly observed in another cohort of 500 patients with colorectal cancer. The k values for CLR evaluation among 8 observers were 0.67 for the 1-mm rule and 0.50 for Graham's criteria. The size of the largest LA best reflects the specific characteristics of CLR, and the 1-mm rule is expected to improve assessment reproducibility.
authors.affiliation: Dept. of Surgery, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan. ueno@ndmc.ac.jp
authors.forename: Hideki
authors.initials: H
authors.lastname: Ueno
authors.forename: Yojiro
authors.initials: Y
authors.lastname: Hashiguchi
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Shimazaki
authors.forename: Eiji
authors.initials: E
authors.lastname: Shinto
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Kajiwara
authors.forename: Kuniaki
authors.initials: K
authors.lastname: Nakanishi
authors.forename: Kei
authors.initials: K
authors.lastname: Kato
authors.forename: Kazuya
authors.initials: K
authors.lastname: Maekawa
authors.forename: Kosuke
authors.initials: K
authors.lastname: Miyai
authors.forename: Takahiro
authors.initials: T
authors.lastname: Nakamura
authors.forename: Junji
authors.initials: J
authors.lastname: Yamamoto
authors.forename: Kazuo
authors.initials: K
authors.lastname: Hase
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000276:immunology* / Q000401:mortality* / Q000473:pathology; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D016246:Lymphocytes, Tumor-Infiltrating / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D055815:Young Adult