THE SIGNIFICANCE OF HISTOPATHOLOGIC FINDINGS IN THE SUBMUCOSAL INVASIVE FRONT OF EARLY COLORECTAL CARCINOMA IN TERMS OF REGIONAL LYMPH NODE METASTASIS

Abstract

We investigated the correlation between the histopathologic findings in the submucosal invasive front of early colorectal carcinoma and the regional lymph node involvement. In 144 patients who underwent curative large bowel resection against early colorectal cancer eleven patients (7.6%) had regional lymph node involvement at the initial operation. We evaluated the relationship between lymph node involvement and following seven factors: budding, vessel permeation, INF, tumor differentiation in the invasive front, mucus collection, the depth of submucosal invasion and the shape of submucosal invasion. Twenty-one percent of budding (+) patients and 16% of ly (+) patients had regional lymph node involvement. In contrast, only 5% of budding (-) patients and 4% of ly (-) patients had it (p<0.05). The lymph node involvement was found in 33% of IFN-γ patients, but in none of INFα. The high rate of lymph node involvement was obtained on the poor tumor differentiation in the invasive front which did not occur in the dominant. The lymph node involvement was not found in all patient with inverted trapezium of the shape of submucosal invasion. In conclusion, the presence of “budding (+)”, “ly (+)”, “INF β or γ”, “moderate or poor tumor differentiation in the invasive front” appears to be a useful predictor for lymph node involvement.