Clinical utility of grading criteria for submucosal invasion in the prognosis of T1 colorectal carcinomas |
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Authors: | Tadahiko Masaki Masanori Sugiyama Hiroyoshi Matsuoka Nobutsugu Abe Yumi Izumisato Akiteru Goto Atsuhiko Sakamoto Yutaka Atomi |
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Institution: | (1) First Department of Surgery, Kyorin University, 6-20-2 Shinkawa, Mitaka, Tokyo 181-8611, Japan, JP;(2) Department of Pathology, Kyorin University, Tokyo, Japan, JP |
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Abstract: | Background: The clinical utility of relative and absolute grading criteria for submucosal invasion in T1 colorectal carcinomas has been
controversial. Methods: In 51 T1 colorectal carcinomas, depth of submucosal invasion was graded either according to a modified Haggitt's classification
(a relative criterion) or by direct measurement using a micrometer (an absolute criterion), and immunostaining for E-cadherin,
α-catenin, β-catenin, matrilysin, and CD44 variant 6 was performed on formalin-fixed, paraffin-embedded sections. The associations
between lymph node metastasis or local recurrence (locoregional failure) and tumor budding, and clinicopathologic parameters
and immunoreactivity were examined statistically. Results: By univariate analysis, tumor budding, histology, and the co-expression pattern of nuclear β-catenin and CD44 variant 6 were
significantly associated with locoregional failure. The relative and absolute grading of submucosal invasion were not significantly
associated with locoregional failure. Multivariate analysis showed that tumor budding alone was significantly associated with
locoregional failure, and the association between the co-expression pattern of nuclear β-catenin and CD44 variant 6, and locoregional
failure was marginally significant (P = 0.0502). Lymphatic invasion and absolute grading of depth and width of submucosal invasion were significantly associated
with tumor budding, and the associations between tumor budding, and histologic differentiation and membranous α-catenin expression
were marginally significant (P = 0.06; P = 0.08), whereas, a relative grading of submucosal invasion was not significant (P = 0.58). Analysis of variance showed that histologic differentiation and lymphatic invasion were independently and significantly
associated with tumor budding (P = 0.005; P < 0.001). Conclusions: These results suggest that the grading of submucosal invasion, either relative or absolute, may not be a useful risk factor
for lymph node metastasis or local recurrence in T1 colorectal carcinomas.
Received: January 16, 2002 / Accepted: May 17, 2002
Acknowledgements. We thank Drs. Y. Shimada, K. Nunomura, and S. Uchiyama for providing tissue blocks. For expert technical assistance we thank
Ms. N. Shiota and Ms. K. Ooshima.
Reprint requests to: T. Masaki |
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Keywords: | : T1 colorectal carcinoma submucosal invasion tumor budding β -catenin CD44 variant 6 |
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