title: Mismatch repair system and p53 expression in patients with T1 and T2 colorectal cancer: predictive role of lymph node metastasis and survival.
abstract: BACKGROUND
  The aim of this study was to evaluate the predictive role of the mismatch repair (MMR) system and p53 expression for lymph node metastasis and long-term survival in patients with T1 and T2 colorectal cancer.
  
  
  METHODS
  A total of 543 patients with T1 or T2 colorectal cancers who underwent radical surgery with regional lymphadenectomy from December 2007 to December 2009 were analyzed. Predictive factors for lymph node metastasis and prognostic factors were analyzed.
  
  
  RESULTS
  During the median follow-up period of 4 years, the 5-year disease-free survival rate for patients without lymph node metastasis was 94.8%, which was significantly higher than that for those with lymph node metastases (85.2%; P < 0.001). On multivariate analysis, gender, tumor location, N category, lymphatic invasion, vascular invasion, and perineural invasion were independent prognostic factors for disease-free survival; however MMR defect, p53 expression, and microsatellite instability (MSI) were not. The presence of lymphatic invasion, vascular invasion, and tumor budding were independent predictors of lymph node metastasis.
  
  
  CONCLUSIONS
  In patients with T1 or T2 colorectal cancer, lymphatic invasion, vascular invasion, and tumor budding were predictive of lymph node metastasis; however, MMR defect, p53 expression, and MSI were not predictive.
authors.affiliation: Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Jung Wook
authors.initials: JW
authors.lastname: Huh
authors.forename: Hee Cheol
authors.initials: HC
authors.lastname: Kim
authors.forename: Seok Hyung
authors.initials: SH
authors.lastname: Kim
authors.forename: Yoon Ah
authors.initials: YA
authors.lastname: Park
authors.forename: Yong Beom
authors.initials: YB
authors.lastname: Cho
authors.forename: Seong Hyeon
authors.initials: SH
authors.lastname: Yun
authors.forename: Woo Yong
authors.initials: WY
authors.lastname: Lee
authors.forename: Ho-Kyung
authors.initials: HK
authors.lastname: Chun
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000556:secondary; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000378:metabolism; D015179:Colorectal Neoplasms / Q000401:mortality* / Q000473:pathology*; D053843:DNA Mismatch Repair; D045643:DNA Repair Enzymes / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007124:Immunoenzyme Techniques; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D053842:Microsatellite Instability; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies; D015996:Survival Rate; D016159:Tumor Suppressor Protein p53 / Q000378:metabolism*
chemical_list: D014408:Biomarkers, Tumor; C495901:TP53 protein, human; D016159:Tumor Suppressor Protein p53; D045643:DNA Repair Enzymes
keywords: early colorectal cancer; lymph node metastasis; prognostic factor