Histopathological features predict metastatic potential in locally advanced colon carcinomas

BMC Cancer

Caren Jayasinghe³  Nektaria Simiantonaki¹  Charles James Kirkpatrick² 

[1] Institute of Pathology Essen-Mitte, Am Deimelsberg 34a, Essen, 45276, Germany

[2] Institute of Pathology, Johannes Gutenberg University, Langenbeckstr. 1, Mainz, 55101, Germany

[3] Department of Pathology, Laboratory Medicine Cologne, Geibelstr. 2, Cologne, 50931, Germany

关键词: Metastasis;    Colon cancer;    Lymphatics;    Blood vessel density;    Necrosis;    Desmoplasia;    Inflammation;    Tumor budding;   

Others  :  1106723
DOI  :  10.1186/s12885-015-1013-7

 received in 2014-07-27, accepted in 2015-01-06,  发布年份 2015

【 摘 要 】

Background

Metastatic dissemination can exist before a pathologically and clinically detectable manifestation. The structural heterogeneity of colon cancer (CC) in histological sections with respect to the morphology of tumor aggressiveness and composition of the tumor microenvironment raises the question of whether the microscopical tumor architecture enables a discrimination of groups with different metastatic potential. This would result in an assessment of the prognosis and provision of an ancillary tool for the therapeutic management after surgery, beside the estimation of the local tumor extent.

Methods

In order to identify predictive biomarkers for metastasis of locally advanced CC, which can easily be integrated into the pathologist’s daily routine diagnostic activity, we determined tumor budding, peritumoral inflammation, extent of desmoplasia and necrosis, density of macro- and microvascular blood vessels and functional state of lymphatics in the tumor center, invasive margin and tumor-free surrounding tissue in 86 non-metastatic, lymphogenous-metastatic and haematogenous-metastatic, subserosa-invasive CC.

Results

Features influencing nodal metastasis in the univariate analysis included high tumor budding (p = 0.004), high large vessel density in the subserosa (p = 0.043), abundant desmoplasia (p = 0.049), non-finger-like desmoplastic pattern (p = 0.051) and absent lymphocellular intratumoral inflammation (p = 0.084). In the multivariate analysis, with the exception of large vessel density, these pathomorphological features were independent risk factors for lymphogenous metastasis (p = 0.023, p = 0.017, p = 0.037, p = 0.012, respectively) with a good discrimination ability (AUC of 0.853). Features associated with distant metastasis in the univariate analysis included high tumor budding (p = 0.002), low intratumoral small vessel density (p = 0.013), absent lymphocellular intratumoral inflammation (p = 0.048) and abundant necrosis (p = 0.073). In the multivariate analysis only tumor budding was an independent predictor for haematogenous metastasis (p = 0.007) with a good discrimination ability (AUC of 0.829).

Conclusions

Thus, mainly tumor budding but also the described structural characteristics of the peritumoral tissue appears to reflect the metastatic potential of locally advanced CC and therefore should be stated in pathological reports.

【 授权许可】

   
2015 Jayasinghe et al.; licensee BioMed Central.

【 图 表 】

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