Assessment of Elastic Laminal Invasion Contributes to an Objective pT3 Subclassification in Colon Cancer.

Autor:	Kojima M; Division of Pathology, Exploratory Oncology, & Clinical Trial Center (EPOC), National Cancer Center., Yokota M; Departments of Surgery., Yanagisawa N; Clinical Research and Trial Center, Juntendo University School of Medicine., Kitamura S; Clinical Research and Trial Center, Juntendo University School of Medicine., Amemiya K; Department of Coloproctological Surgery, Juntendo University Faculty of Medicine., Kawano S; Department of Coloproctological Surgery, Juntendo University Faculty of Medicine., Tsukada Y; Departments of Colorectal Surgery., Sakuyama N; Department of Surgery, IMSUT Hospital, The Institute of Medical Science, The University of Tokyo., Nagayasu K; Department of Surgery, Tobu Chiiki Hospital, Metropolitan Health and Medical Treatment Corporation., Hashimoto T; Departments of Pathology and Clinical Laboratories., Nakashima K; Department of Diagnostic Pathology, Kurume University Hospital., Jiang K; Department of Pathology, Moffitt Cancer Center, Tampa, FL., Kanemitsu Y; Colorectal Surgery, National Cancer Center Hospital., Fujita F; Department of Surgery, Kurume University School of Medicine, Kurume, Fukuoka Prefecture, Japan., Akiba J; Department of Diagnostic Pathology, Kurume University Hospital., Notohara K; Anatomic Pathology, Kurashiki Central Hospital, Kurashiki, Okayama Prefecture., Itakura J; Anatomic Pathology, Kurashiki Central Hospital, Kurashiki, Okayama Prefecture., Sekine S; Departments of Pathology and Clinical Laboratories., Sakashita S; Division of Pathology, Exploratory Oncology, & Clinical Trial Center (EPOC), National Cancer Center., Sakamoto N; Division of Pathology, Exploratory Oncology, & Clinical Trial Center (EPOC), National Cancer Center., Ishikawa S; Division of Pathology, Exploratory Oncology, & Clinical Trial Center (EPOC), National Cancer Center., Nakanishi Y; Department of Pathology, Moffitt Cancer Center, Tampa, FL., Yao T; Department of Human Pathology, Graduate School of Medicine, Juntendo University, Tokyo., Liang WY; Department of Pathology and Laboratory Medicine, Veterans General Hospital-Taipei, Taipei, Republic of China., Lauwers GY; Department of Pathology, Moffitt Cancer Center, Tampa, FL., Ito M; Departments of Colorectal Surgery., Sakamoto K; Department of Coloproctological Surgery, Juntendo University Faculty of Medicine., Ishii G; Pathology and Clinical Laboratories, National Cancer Center Hospital East, Kashiwa, Chiba Prefecture., Ochiai A; Division of Pathology, Exploratory Oncology, & Clinical Trial Center (EPOC), National Cancer Center.
Jazyk:	angličtina
Zdroj:	The American journal of surgical pathology [Am J Surg Pathol] 2023 Oct 01; Vol. 47 (10), pp. 1122-1133. Date of Electronic Publication: 2023 Jun 30.
DOI:	10.1097/PAS.0000000000002090
Abstrakt:	The extent of tumor spread influences on the clinical outcome, and which determine T stage of colorectal cancer. However, pathologic discrimination between pT3 and pT4a in the eighth edition of the American Joint Committee on Cancer (AJCC)-TNM stage is subjective, and more objective discrimination method for deeply invasive advanced colon cancer is mandatory for standardized patient management. Peritoneal elastic laminal invasion (ELI) detected using elastic staining may increase the objective discrimination of deeply invasive advanced colon cancer. In this study, we constructed ELI study group to investigate feasibility, objectivity, and prognostic utility of ELI. Furthermore, pT classification using ELI was investigated based on these data. At first, concordance study investigated objectivity using 60 pT3 and pT4a colon cancers. Simultaneously, a multi-institutional retrospective study was performed to assess ELI's prognostic utility in 1202 colon cancer cases from 6 institutions. In the concordance study, objectivity, represented by κ, was higher in the ELI assessment than in pT classification. In the multi-institutional retrospective study, elastic staining revealed that ELI was a strong prognostic factor. The clinical outcome of pT3 cases with ELI was significantly and consistently worse than that of those without ELI. pT classification into pT3 without ELI, pT3 with ELI, and pT4a was an independent prognostic factor. In this study, we revealed that ELI is an objective method for discriminating deeply invasive advanced colon cancer. Based on its feasibility, objectivity, and prognostic utility, ELI can subdivide pT3 lesions into pT3a (without ELI) and pT3b (with ELI). Competing Interests: Conflicts of Interest and Source of Funding: Supported by the JSPS KAKENHI Number JP18007279. The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article. (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)
Databáze:	MEDLINE
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