Relative effects of direct spread, lymph node metastasis and venous invasion in relation to blood borne distant metastasis present at the time of resection of colorectal cancer

Background and Aims. Various risk factors for lymph node metastasis (LNM) have been reported in colorectal T1 cancers. However, the factors available are insufficient for predicting LNM. We therefore investigated the utility of the new histological factor “pure well-differentiated adenocarcinoma” (PWDA) as a safe factor for predicting LNM in T1 and T2 cancers. Materials and Methods. We reviewed 115 T2 cancers and 202 T1 cancers in patients who underwent surgical resection in our center. We investigated the rates of LNM among various clinicopathological factors, including PWDA. PWDA was defined as a lesion comprising only well-differentiated adenocarcinoma. The consistency of the diagnosis of PWDA was evaluated among two pathologists. In addition, 72 T1 cancers with LNM from 8 related hospitals over 10 years (2008–2017) were also analyzed. Results. The rates of LNM and PWDA were 23.5% and 20.0%, respectively, in T2 cancers. Significant differences were noted between patients with and without LNM regarding lymphatic invasion (81.5% vs. 36.4%, p<0.001), poor histology (51.9% vs. 19.3%, p=0.008), and PWDA (3.7% vs. 25.0%, p=0.015). The rates of LNM and PWDA were 8.4% and 36.1%, respectively, in T1 cancers. Regarding the 73 PWDA cases and 129 non-PWDA cases, the rates of LNM were 0.0% and 13.2%, respectively (p<0.001). Among the 97 cases with lymphatic or venous invasion, the rates of LNM in 29 PWDA cases and 68 non-PWDA were 0% and 14.7%, respectively (p=0.029). The agreement of the two pathologists for the diagnosis of PWDA was acceptable (kappa value > 0.5). A multicenter review showed no cases of PWDA among 72 T1 cancers with LNM. Conclusions. PWDA is considered to be a safe factor for LNM in T1 cancer.

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The role of microvessel density, lymph node metastasis, and tumor size as prognostic factors of distant metastasis in colorectal cancer

Oncology Letters ◽

10.3892/ol.2017.5959 ◽

2017 ◽

Vol 13 (6) ◽

pp. 4327-4333 ◽

Cited By ~ 8

Author(s):

Tomonari Cho ◽

Eisuke Shiozawa ◽

Fumihiko Urushibara ◽

Nana Arai ◽

Toshitaka Funaki ◽

...

Keyword(s):

Colorectal Cancer ◽

Prognostic Factors ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Distant Metastasis ◽

Microvessel Density ◽

Tumor Size ◽

Node Metastasis

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DSG2 expression is low in colon cancer and correlates with poor survival

BMC Gastroenterology ◽

10.1186/s12876-020-01588-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Tingting Yang ◽

Xuan Gu ◽

Lizhou Jia ◽

Jiaojiao Guo ◽

Qi Tang ◽

...

Keyword(s):

Colon Cancer ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Distant Metastasis ◽

Bioinformatics Analysis ◽

Venous Invasion ◽

Migration And Invasion ◽

Poor Survival ◽

Node Metastasis ◽

Ajcc Stage

Abstract Background Desmoglein2 (DSG2) is a transmembrane protein that helps regulate intercellular connections and contributes to desmosome assembly. Desmosome are associated with cell adhesion junctions, which play an important role in cancer progression specially cancer cell migration and invasion. However, DSG2 expression in colon cancer (CC) and its association with CC patients’ overall survival (OS) are still unclear. Methods We collected 587 CC samples, 41 colitis tissues and 114 pericarcinomatous tissues, as well as corresponding clinicopathological data about the patients who contributed them. All samples were tested immunohistochemically in tissue microarrays. Kaplan–Meier method was used for calculating patient survival. Univariate and multivariate analyses was used for investigating DGS2 link with CC patient’s clinicopathological factors. Bioinformatics analysis was also used in study. Results The results showed that DSG2 expression was lower in CC tissues than in pericarcinomatous tissues (P < 0.001). DSG2 expression was associated with differentiation (P = 0.033), lymph node metastasis (P = 0.045), distant metastasis (P = 0.006) and AJCC stage (P < 0.001). Univariate analysis indicated that poor OS in patients with CC was associated with low DSG2 expression (P < 0.001), tumor size (P < 0.001), lymph node metastasis (P < 0.001), distant metastasis (P < 0.001), AJCC stage (P < 0.001) and venous invasion (P < 0.001). In multivariate analysis, low DSG2 expression (P < 0.001), distant metastasis (P < 0.001), AJCC stage (P = 0.002), venous invasion (P < 0.001) were independent prognostic factors for CC patients. Bioinformatics analysis indicated that low DSG2 expression affects protein activation, regulates the P53-related pathway in CC, and activates the EGFR pathway. Conclusions The results suggest that low DSG2 expression is associated with poor survival for CC patients. DSG2 could be a prognostic biomarker for CC.

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Expression of Hepcidin and Neogenin in colorectal cancer

Open Medicine ◽

10.1515/med-2017-0027 ◽

2017 ◽

Vol 12 (1) ◽

pp. 184-188 ◽

Cited By ~ 2

Author(s):

Pan Xiang-tao

Keyword(s):

Colorectal Cancer ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Distant Metastasis ◽

Biological Behavior ◽

Node Metastasis ◽

T Stage ◽

Significant Difference ◽

Anemia Group ◽

The Relationship

AbstractObjectiveTo investigate the expression of Hepcidin and Neogenin in tissue from patients with colorectal cancer, to evaluate the relationship between Hepcidin and Neogenin with clinical features, and to study their relationship with anemia.MethodsImmuno- histochemical method was used to detect the expression of Hepcidin and Neogenin in 62 cases of colorectal cancer. At the same time, the relationship between them and their relationship with clinical characteristics and anemia were analyzed.ResultsThe expression of Hepcidin was related to T stage (P<0.05), but not with age, gender, lymph node metastasis and distant metastasis. The expression of Neogenin was not correlated with T stage and lymph node metastasis, age, gender, and distant metastasis (P>0.05). There was no significant difference in the expression of Hepcidin and Neogenin between anemia group and non-anemia group. There was no correlation between Hepcidin and Neogenin (r =-0.04, P>0.05).ConclusionThe expression of Hepcidin in colorectal cancer was related to the T stage, and had no correlation with Neogenin. The expression of Neogenin could not be used as an objective index to reflect the biological behavior of colorectal cancer.

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IS A STUDY OF THE LEVEL OF CARBOHYDRATE ANTIGEN (CA 19-9) EFFECTIVE IN PATIENTS WITH COLORECTAL CANCER?

Problems in oncology ◽

10.37469/0507-3758-2020-66-5-528-534 ◽

2020 ◽

Vol 66 (5) ◽

pp. 528-534

Author(s):

Ye. Rybakov ◽

Mikhail Tarasov ◽

S. Chernyshov ◽

Marina Sukhina ◽

V. Charikov ◽

...

Keyword(s):

Colorectal Cancer ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Distant Metastasis ◽

Perineural Invasion ◽

Serum Levels ◽

Lymphatic Invasion ◽

Node Metastasis ◽

Preoperative Serum ◽

Invasion Stage

Objective. Саrbohydrаte antigen 19-9 (CA 19-9) is the frequently used tumor marker in the clinical setting of colorectal cancer (CRC). This study was designed to investigate the correlation between preoperative serum levels of CA 19-9 (pre-CA 19-9) and the clinicopathologic factors of patients with CRC. Patients and methods. A study was performed on 482 patients with histologically diagnosed colorectal adenocarcinoma between January 2016 and December 2017, based on retrospective collected data. The clinical data such as age, sex, size of tumor, differentiation (G), depth of tumor (T), lymph node metastasis (N), distant metastasis (M), lymphatic invasion, venous invasion, perineural invasion, stage, and preoperative serum levels of CEA (pre-CEA) and pre-CA 19-9 were obtained. These patients were classified into two groups according to pre-CA 19-9 (CA 19-9 high: H37 U/mL; CA 19-9 normal: H37 U/mL). Results. Eighty five patients among 483 patients (17.6%) with CRC showed a high pre-CA 19-9. The elevationof pre-CA 19-9 was significantly associated with size of tumor > 4.5 cm (р=0.0001), higt CEA > 5ng/ml (р<0.0001), wrong differenciation of tumor (р=0.0003), depth of tumor (р<0.0001), lymph node metastasis (р<0.0001), distant metastasis (р<0.0001), lymphatic invasion (р=0.0013), vascular invasion (р<0.0001), perineural invasion (р<0.0001), stage (р<0.0001). On multivariate analysis, high pre-CA 19-9 was shown to be independently associated with depth of tumor (р=0.05), lymph node metastasis (р=0.0006). Spearman>s correlation coefficient r between REA and CA 19-9 was 0.21 (95% CI 0.13 - 0.30; p<0.0001). Conclusion. High pre-CA 19-9 in advanced colorectal cancer might provide important information to predict the depth of tumor, lymph node metastasis.

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Upregulation of The Transmembrane Protease Serine 3 (TMPRSS3) mRNA Level In Radioresistant Colorectal Cancer Tissues

10.21203/rs.3.rs-783489/v1 ◽

2021 ◽

Author(s):

Jia-Ying Wen ◽

Ye-Ying Fang ◽

Gang Chen ◽

Rong-Quan He ◽

He-Qing Huang ◽

...

Keyword(s):

Colorectal Cancer ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Distant Metastasis ◽

Pooled Analysis ◽

P Value ◽

Data Sets ◽

Hub Genes ◽

Node Metastasis ◽

The Relationship

Abstract BackgroundPrevious studies have shown that transmembrane protease serine 3 (TMPRSS3) is abnormally expressed in various tumours and its expression is closely related to tumorigenesis and progression [1-3]. However, there have been no reports regarding the role of TMPRSS3 in colorectal cancer (CRC). The aim of the current study was to comprehensively explore the clinical value of TMPRSS3 on the radioresistance of CRC.MethodsIn this study, we evaluated the expression level of TMPRSS3 in radioresistant CRC tissues as well as CRC tissues by analysing public data sets from the Cancer Genome Atlas (TCGA), Gene Expression Omnibus (GEO), ArrayExpress, and GTEx databases, as well as explored the relationship between TMPRSS3 and lymph node metastasis, distant metastasis, and prognosis. In addition, we investigated the biological function of TMPRSS3 by gene ontology (GO) and analysis of the Kyoto Encyclopaedia of Genes and Genomes (KEGG). Finally, we created a protein-protein interaction (PPI) network to identify hub genes that may function in concert with TMMPRSS3.ResultsEight radiation-processed CRC tissue data sets and 26 CRC mRNA data sets were obtained. The pooled analysis revealed that TMPRSS3 was significantly highly expressed in CRC radioresistant tissues—SMD = 0.38 (95% CI: 0.14~0.63; p-value < 0.05). In addition, TMPRSS3 is also as highly expressed in CRC tissues—SMD = 1.55 (95% CI: 1.20~1.90; p-value < 0.05). Subsequently, we explored the relationship between TMPRSS3 and both metastasis and prognosis. The results revealed no relationship between TMPRSS3 and lymph node metastasis and distant metastasis (p-value > 0.05). Furthermore, pooled analysis of HR revealed that TMPRSS3 could be used as a risk factor for DFS—SMD = 1.28 (95% CI: 1.03~1.60; p-value < 0.05). Finally, we obtained 429 co-expressed genes for bioinformatics analysis and selected a total of four hub genes: MSLN, MFI2, CKAP4, and PXN. The results revealed that these genes cooperate with TMPRSS3 to participate in biological processes, such as CRC development, metastasis, and radioresistance by affecting autophagy, cell-cell adhesion, and extracellular matrix breakdown.ConclusionThis study reveals that TMPRSS3 has potential as a new biomarker and radioresistant therapeutic target for CRC and also has a few implications for the prognosis of CRC patients. However, this conclusion must be further experimentally verified.

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Clinicopathological Significance and Diagnostic Accuracy of HER2 Immunohistochemistry in Colorectal Cancer: A Meta-Analysis

The International Journal of Biological Markers ◽

10.5301/jbm.5000208 ◽

2016 ◽

Vol 31 (4) ◽

pp. 389-394 ◽

Cited By ~ 3

Author(s):

Jung-Soo Pyo ◽

Guhyun Kang ◽

Kyeongmee Park

Keyword(s):

Colorectal Cancer ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Diagnostic Accuracy ◽

Distant Metastasis ◽

Meta Analysis ◽

Test Accuracy ◽

Her2 Expression ◽

Node Metastasis ◽

Clinicopathological Significance

Introduction The aim of this study was to elucidate the clinicopathological significance of HER2 expression and the diagnostic accuracy of HER2 immunohistochemistry (IHC) in colorectal cancer (CRC). A total of 2,573 CRC cases from 13 eligible studies were included. Methods We performed a meta-analysis to examine the correlations between HER2 expression and clinicopathological characteristics in CRC. Concordance analysis between HER2 IHC and in situ hybridization (ISH) and diagnostic test accuracy review was conducted. Results The estimated rate of HER2 IHC overexpression was 0.162 (95% confidence interval [CI] 0.106-0.240). HER2 IHC overexpression was significantly correlated with lymph node metastasis and distant metastasis but not tumor depth. HER2 IHC overexpression was not correlated with overall survival. The concordance rates between IHC and ISH were 0.968 (95% CI 0.881-0.992), 0.377 (95% CI 0.225-0.557) and 0.780 (95% CI 0.390-0.952) for HER2 IHC scores of 0/1+, 2+ and 3+, respectively. The diagnostic test accuracy review of HER2 IHC revealed that the pooled sensitivity and specificity were 0.71 (95% CI 0.58-0.82) and 0.96 (95% CI 0.94-0.97), respectively. The diagnostic odds ratio and area under the summary receiver operating characteristic curve were 51.34 (95% CI 3.82-690.54) and 0.9704, respectively. Conclusions HER2 IHC overexpression was significantly correlated with lymph node metastasis and distant metastasis. CRC cases with HER2 IHC scores of 0/1+ exhibited good agreement with the ISH data. However, additional ISH analysis is needed to confirm HER2 status in cases with IHC scores of 2+ or 3+.

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Clinicopathological factors associated with synchronous distant metastasis and prognosis of stage T1 colorectal cancer patients

10.21203/rs.3.rs-118022/v1 ◽

2020 ◽

Author(s):

Weiping Chen ◽

Qiken Li ◽

Gang Wang ◽

Jun Luo ◽

Bo Li

Keyword(s):

Colorectal Cancer ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Cancer Patients ◽

Distant Metastasis ◽

Node Metastasis ◽

T1 Colorectal Cancer ◽

Colorectal Cancer Patients ◽

Stage T1 ◽

Synchronous Distant Metastasis

Abstract It is rare and understudied for patients with stage T1 colorectal cancer to have synchronous distant metastasis. This study was to determine the clinicopathological factors associated with distant metastasis and prognosis. T1 colorectal cancer patients diagnosed between 2010 and 2015 were obtained from the SEER database. Logistic regression was applied to determine risk factors related to distant metastasis. Cox-proportional hazard models were used to identify the prognostic factors for patients with distant metastasis. Among 21,321 patients identified, 359 (1.8%) had synchronous distant metastasis and 1807 (8.5%) had lymph node metastasis. Multivariate analysis revealed that younger age, positive serum CEA, larger tumor size, positive tumor deposit, perineural invasion, lymph node metastasis, histology of non-adenocarcinoma and poorer differentiation were significantly associated with the increased risk of synchronous distant metastasis. Older age, female, African American, positive CEA, positive lymph node metastasis, positive tumor deposit, larger tumor size, no chemotherapy, inadequate lymph node harvesting and no metastasectomy were correlated with worse survival in these patients with synchronous distant metastasis. Patients with metastasis to the liver displayed the highest rate of positive CEA. We conclude that T1 colorectal cancer patients with multiple risk factors need thorough examinations to exclude synchronous distant metastasis. Chemotherapy, adequate lymph node cleaning and metastasectomy are associated with improved survival for those patients with distant metastases. Positive serum CEA may be useful in predicting distant metastases in patients at stage T1.

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