Detection of metastatic cancer cells in mesentery of colorectal cancer patients

Abstract

AIMTo detect the existence of isolated cancer cells in the mesentery of colorectum (named as Metastasis V), and investigate its clinical significance in colorectal cancer (CRC) patients.METHODSSixty-three CRC patients who received radical excision between January 2012 and September 2015 were included. All the patients underwent laparoscopy-assisted radical colorectomy or proctectomy [with complete mesocolic excision (CME) or total mesorectal excision (TME)] with R0 dissections at the Department of Gastrointestinal Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology. The location and size of the primary lesions were recorded immediately after the tumor was removed, with the surrounding mesenterium completely separated along the intestinal wall. Each dissected mesentery sample was analyzed for hematoxylin-eosin staining and immunohistochemistry using cytokeratin 19 antibody. Image Pro Plus Software 6.0 (Media Cybernetics, CA, United States) was used to semi-quantitatively measure the concentration of the cytokeratin 19 immunohistochemistry. The correlation between metastasis found in mesentery and clinicopathological characteristics was examined. The prognosis of patients was also evaluated by preoperative serum CEA level.RESULTSMetastasis V was detected in 14 of 63 (22.2%) CRC patients who underwent laparoscopy-assisted radical colorectomy or proctectomy (with CME or TME) with R0 dissection in our hospital between January 2012 and September 2015. There was no significant difference in age, gender, tumor size, and tumor location in patients with Metastasis V (P > 0.05). Metastasis V was more likely to occur in poorly differentiated tumor (5/11; 45.5%) than moderately (8/46; 17.4%) and well- differentiated one (1/6; 16.7%). The Metastasis V in N2 stage (9/14; 64.3%) was more frequent that in the N0 stage (3/35; 8.6%) or N1 stages (2/14; 14.3%). In addition, Metastasis V was positively related to the tumor invasive depth (T1:0/1, 0%; T2:1/12, 8.3%; T3:7/39, 17.9%; T4:6/11, 54.5%). Furthermore, preoperative serum CEA level in Metastasis V-positive patients was significantly higher than in Metastasis V-negative patients (4.27 ng/mL vs 3.00 ng/mL).CONCLUSIONMetastasis V might be associated with a poor prognosis of CRC patients.

Increased expression of epithelial cell adhesion molecule and its possible role in epithelial–mesenchymal transition in endometriosis

“…Under ×200 microscopic fields (×20 objective, ×10 ocular), the most stained fields were captured by a digital camera connected to a computer. Immunohistochemically stained epithelial cells were quantified by a computerized image analysis software, Image Pro‐Plus Version 6.0 (Media Cybernetics, Inc) 21–24 . Quantification of immunohistochemical results was split into seven steps: (i) find and gather the interested field in the slide; (ii) adjust the optical brightness; (iii) screenshot and save the image; (iv) modify the background; (v) configure the immunohistochemically stained parts in the image; (vi) examine integrated optical density (IOD) and total stained area (S); (vii) calculate mean optical density (MOD), which is defined as MOD = IOD/S.…”

The Clinical Significance of Mesenteric Lymphocytes in Human Colorectal Cancer

“…Distribution of tumors per the N stage was as follows: N0 stage (17 patients), N1 stage ( 9 ), and N2 stage ( 6 ). The distribution of tumors per the M stage was as follows: M0 stage (17 patients), M1 stage ( 5 ), and Mx stage ( 10 ). The preoperative serum carcinoembryonic antigen (CEA) levels were ≥5 ng/mL and <5 ng/mL in 11 and 21 patients, respectively.…”

“…The mesentery is a continuous membrane that attaches the intestines to the abdominal wall and is considered a potential site of residual tumor ( 7 , 8 ). Metastatic cancer cells were detected in the colorectal mesentery in approximately 20% of patients with CRC, who underwent radical surgery ( 9 , 10 ), and patients with mesenteric metastasis tend to show poor cumulative survival rates ( 11 , 12 ).…”

Resectional surgery for malignant disease of abdominal digestive organs is not surgery of the organ itself, but also that of the mesenteric organ

“…Isolated metastases (also termed tumour deposits) can be found within the mesentery [16] and are apparently (at least histologically) independent of blood vessels, lymphatic channels and nerves. Tumour deposits are potentially explained by recent findings related to the mesentery and intestine.…”