Lymphovascular and Perineural Invasions Are Independently Associated with Advanced Colorectal Carcinoma

Abstract

Background: Lymphovascular invasion (LVI) and perineural invasion (PNI) are relatively common in various malignancies including colorectal cancers and have been shown to have prognostic significance. Objectives: The aim of this study was to identify the clinical and pathological variables associated with LVI and PNI in patients with colorectal carcinoma, who have been treated at Milad General Hospital in Tehran, Iran. Methods: The records of the patients with the diagnosis of colorectal carcinoma, who had undergone an operation at Milad General Hospital (Tehran, Iran) between 2012 and 2017, were reviewed. All patients, whose pathology reports and treatment records were available at Milad Hospital, were included. Relevant demographic, pathological, and surgical data, including age, gender, tumor location, maximum tumor size, pathologic Tumor, Node, Metastasis (TNM) stage, and grade and number of removed lymph nodes were extracted from the medical records. Results: In total, 547 patients (374 cases of colon cancer and 173 cases of rectal cancer) enrolled in the study. The prevalence of LVI and PNI was 16.4% and 30.7%, respectively. LVI and PNI were found to be associated with higher tumor grade, higher T-stage, and higher overall stage. Conclusions: Colorectal carcinomas with positive LVI or PNI are more likely to have a higher grade, higher T-stage, and higher overall stage, and PNI is an independent factor for advanced disease.

Pathological Characteristics, Prognostic Determinants and the Outcome of Patients Diagnosed with Colorectal Adenocarcinoma at the University Teaching Hospital of Kigali

“…In a retrospective review which was performed in the USA on the National Cancer Database (NCDB), 2004–2011, positive margins were 39.7% [ 14 ]. In their study, Yahyazadeh et al found that lymph vascular invasion was present in 16.4%, whereas perineural invasion was 30.7%, the study was conducted in Iran [ 15 ]. The results about perineural invasion and margins status from those two studies are comparable with the results of the present study.…”

“…The results about perineural invasion and margins status from those two studies are comparable with the results of the present study. Considering lymphocytic infiltration on H and E staining, there was a high immune response in 71.3% cases, though IHC (CD8 and CD3) were not performed for the characterization of those lymphocytes, but previous research studies have indicated that local lymphocytosis is associated with a favorable prognosis as it has been demonstrated by Klintrup and Mäkinen [ 6 , 15 – 17 ]. Also, it is known that cytotoxic T lymphocyte antigen-4 expressed in tumoral infiltrating lymphocytes and CRC cells is an inhibitory immune check point that can interfere with antitumoral drugs and cause poor prognosis with metastasis of the disease in some cases [ 18 ].…”

Anatomical Distribution of Colon Cancer: A Retrospective 10-Year Study to Evaluate Rightward Shift in Two Referral Hospitals in Iran

“…During the last 25 years, the incidence of colorectal cancer has increased in Iran and based on the national registry, it is the third most common cancer in Iran following cancers of the breast and stomach with an annual incidence of more than 7100 cases (2).…”