title: Predictors of lymph node metastasis in T1 colorectal carcinoma: an immunophenotypic analysis of 265 patients.
abstract: BACKGROUND
  The appropriateness of endoscopic resection in patients with T1 colorectal carcinomas is unclear. Highly precise predictors of lymph node metastasis are required to optimize the outcomes of treatments for T1 colorectal carcinomas.
  
  
  OBJECTIVE
  The purpose of this work was to identify predictors of lymph node metastasis by examining the clinicopathologic significance of immunophenotypes found in T1 colorectal carcinomas.
  
  
  METHODS
  This was a retrospective study.
  
  
  METHODS
  The study was conducted at a university hospital.
  
  
  METHODS
  Included were 265 patients with T1 colorectal carcinoma who underwent radical surgery.
  
  
  METHODS
  Patients with T1 colorectal carcinoma were managed.
  
  
  METHODS
  Immunophenotypes were associated with various clinicopathologic parameters, and CD10 expression was strongly associated with lymph node metastasis.
  
  
  RESULTS
  The levels of MUC2, MUC5AC, and CD10 expression were individually significantly associated with tumor location, growth pattern, histologic type, invasive potential, and metastatic potential. The incidence of lymph node metastasis was significantly associated with each of the 5 following parameters: depth of submucosal invasion (p = 0.005), tumor budding (p < 0.001), lymphatic invasion (p < 0.001), MUC2 expression (p = 0.006), and CD10 expression (p < 0.001). Multivariate analysis showed that CD10 expression (OR, 9.2 [95% CI, 2.5-39.8]; p = 0.001) and lymphatic invasion (OR, 6.3 [95% CI, 2.5-17.7]; p < 0.001) were independently associated with lymph node metastasis.
  
  
  CONCLUSIONS
  This study was limited by its small sample size, intraobserver variation attributed to immunohistochemical staining, and potential selection bias because surgically resected specimens were collected instead of endoscopically resected specimens.
  
  
  CONCLUSIONS
  We suggest that CD10 expression is closely associated with lymph node metastasis in T1 colorectal carcinoma.
authors.affiliation: 1Department of Pathology, Osaka Medical College, Osaka, Japan 2Department of General and Gastroenterological Surgery, Osaka Medical College, Osaka, Japan.
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Nishida
authors.forename: Yutaro
authors.initials: Y
authors.lastname: Egashira
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Akutagawa
authors.forename: Mototsugu
authors.initials: M
authors.lastname: Fujii
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Uchiyama
authors.forename: Yuro
authors.initials: Y
authors.lastname: Shibayama
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Hirose
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000276:immunology; D015179:Colorectal Neoplasms / Q000276:immunology* / Q000473:pathology* / Q000601:surgery*; D004724:Endoscopy; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D016130:Immunophenotyping; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D055271:Mucin 5AC / Q000276:immunology; D055262:Mucin-2 / Q000276:immunology; D060787:Neoplasm Grading; D015260:Neprilysin / Q000276:immunology; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D014408:Biomarkers, Tumor; C524625:MUC2 protein, human; C524678:MUC5AC protein, human; D055271:Mucin 5AC; D055262:Mucin-2; D015260:Neprilysin