Tumor budding as a risk factor of lymph node metastasis in submucosal invasive T1 colorectal carcinoma: a retrospective study.
Tumor budding as a risk factor of lymph node metastasis in submucosal invasive T1 colorectal carcinoma: a retrospective study.
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DOI：
10.1186/1471-2482-12-16
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发表时间：
2012-08-06
期刊：
影响因子：
1.9
通讯作者：
Kim JG
中科院分区：
文献类型：
--
作者：
Kye BH;Jung JH;Kim HJ;Kang SG;Cho HM;Kim JG
本研究旨在探讨早期结直肠癌淋巴结转移的危险因素，该癌在根治性切除术后被证实为浸润粘膜下层的癌。回顾性评价了2007年1月至2010年9月在韩国天主教大学圣文森特医院外科接受根治性切除术的病理学显示粘膜下浸润性结直肠癌的55例患者。肿瘤大小、粘膜下浸润深度、组织学分级、淋巴管浸润、肿瘤出芽和微腺泡结构由一位病理学家进行审查。连续变量采用Student t检验，分类变量采用卡方检验，比较两组患者的临床病理特征（有无淋巴结转移）。连续变量表示为平均值±标准误差，而统计学显著性在P < 0.05时被接受。55例患者（34例男性和21例女性）的平均年龄为61.2 ± 9.6岁（范围：43-83岁）。组织学上，8例（14.5%）患者有淋巴结转移。在单因素分析中，肿瘤出芽（P = 0.047）是唯一与淋巴结转移显著相关的因素。同时，肿瘤出芽对黏膜下浸润性T1结直肠癌淋巴结转移的敏感性为83.3%，特异性为60.5%，阴性预测值为0.958。肿瘤出芽似乎具有较高的敏感性（83.3%），可接受的特异性（60.5%）和较高的阴性预测值（0.958）。为了正确处理早期结直肠癌，应仔细检查病理结果，包括肿瘤出芽。
This study was designed to identify risk factors for lymph node metastasis of early stage colorectal cancer, which was confirmed to a carcinoma that invaded the submucosa after radical resection. In total, 55 patients revealing submucosal invasive colorectal carcinoma on pathology who underwent curative radical resection at the Department of Surgery, St. Vincent’s Hospital, The Catholic University of Korea from January 2007 to September 2010 were evaluated retrospectively. Tumor size, depth of submucosal invasion, histologic grade, lymphovascular invasion, tumor budding, and microacinar structure were reviewed by a single pathologist. Student t-test for continuous variables and Chi-square test for categorical variables were used for comparing the clinicopathological features between two groups (whether lymph node involvement existed or not). Continuous variables are expressed as the mean ± standard error while statistical significance is accepted at P < 0.05. The mean age of 55 patients (34 males and 21 females) was 61.2 ± 9.6 years (range, 43–83). Histologically, eight (14.5%) patients had metastatic lymph node. In the univariate analysis, tumor budding (P = 0.047) was the only factor that was significantly associated with lymph node metastasis. Also, the tumor budding had a sensitivity of 83.3%, a specificity of 60.5%, and a negative predictive value of 0.958 for lymph node metastasis in submucosal invasive T1 colorectal cancer. The tumor budding seems to have a high sensitivity (83.3%), acceptable specificity (60.5%), and a high negative predictive value (0.958). A close examination of pathologic finding including tumor budding should be performed in order to manage early CRC properly.
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