Histopathological Study of Factors for the Prognosis of stage II Carcinoma of Colon and Rectum

Abstract

Histopathological factors that influence the prognosis of stage II carcinoma of colon and rectum were studied using 50 surgical materials, all cases of which had been appeared to be curably operated.
They were divided into two groups. The group A, included worse prognostic 25 cases with local recurrence and/or distant metastasis. The group B included better prognostic 25 cases without any recurrence and/or metastasis for 5 years after surgical treatment. The comparative study between A and B groups was made about degree of main histological differentiation of carcinoma, hisological dedifferentiating features at the edge of invasion of subserosa and serosa, infiltrative mode, depth of invasion and both lymphatic and venous vascular invasion.
The results are as followings.
As to main histological differentiation, well differentiated adenocarcinoma (well) acco-unted for llcases, moderately differentiated adenocarcinoma (mod) for 11 and mucinous carcino-ma (muc) for 3 in group A. In group B, well accounted for 16, mod for 7 and muc for 2. Group A revealed the dedifferentiated feature at the edge of invasion of subserosa and serosa more clearly in contrast to group B. Concerning infiltrative mode (inf), expansive growth (a) accounted for 8 and expansive and infiltrative growth (β) for 17 in group A. In group B, a accounted for 16 and β for 9.
The depth of invasion was ss (a₁) in 9 and s (a₂) in 16 in group A and ss (a₁) in 21 and s (a₂) in 4 in group B. The incidence of venous invasion was 96% in group A and 64% of group B. The incidence of lymphatic vessel invasion showed no significant difference between them.
The results suggest that degree of main histological differentiation, at the invasive borders, infiltrative mode, depth of invasion and venous invasion are important histopathological factors to predict the prognosis of stage II carcinoma of the colon and rectum.