Histopathological predictors of regional lymph node metastasis at the invasive front in early colorectal cancer

作者：Akishima Fukasawa Yuri^*; Ishikawa Yukio; Akasaka Yoshikiyo; Uzuki Miwa; Inomata Naomi; Yokoo Tomoko; Ishii Ryuga; Shimokawa Reiko; Mukai Kiyoshi; Kiguchi Hideko; Suzuki Koyu; Fujiwara Mieko; Ogata Kentaro; Niino Hitoshi; Sugiura Hitoshi; Ichinose Akihiro; Kuroda Yoshikazu; Kuroda Daisuke; Ishii Toshiharu

来源：Histopathology, 2011, 59(3): 470-481.

DOI：10.1111/j.1365-2559.2011.03964.x

• ANGPTL4
• CXCL12
• early colorectal cancer
• invasive front
• lymph node metastasis
• LYVE-1
• MMP-7
• neutrophil infiltration

Aims: In early colorectal cancer (ECC), prediction of lymph node (LN) metastasis is vital for the decision of additional surgical treatment after endoscopic mucosal/submucosal resection. The aim of this study was to determine the relationship between LN metastasis and comprehensive histopathological findings including the cancer microenvironment in ECC.
Methods and results: Using 111 ECC cases, including 36 cases with LN metastasis, histopathological observations and immunohistochemistry for lymphatic vessel endothelial hyaluronan receptor-1 (LYVE-1), von Willebrand factor, matrix metalloproteinase-7 (MMP-7), CXC chemokine ligand-12 (CXCL12) and angiopoietin-like-4 (ANGPTL4) were conducted. Relationships between LN metastasis and growth pattern, status of muscularis mucosae, depth of cancer invasion, overall histopathological type, histopathological type at the invasive front, tumour budding, neutrophil infiltration in cancer cells (NIC), fibrotic cancer-stroma type, Crohn's-like lymphoid reaction, microscopic abscess formation and lymphatic invasion were determined. In addition, the expression of MMP-7, CXCL12 and ANGPTL4 in cancer cells at the invasive front were also considered in the context of LN metastasis. By multivariate analysis, lymphatic invasion, NIC and MMP-7 expression at the invasive front were independent predictors of LN metastasis.
Conclusions: LN metastasis is regulated not only by the characteristics of cancer cells but also by microenvironmental factors of lymphatics and neutrophils, especially at the invasive front.

• 出版日期2011-9