The Detection of Lymphatic Invasion in Colorectal Polyp Cancer Using D2-40 Immunohistochemistry and Its Association With Prognosis

Goodarzi, Mohammad R.; Mansouri, David; Kidd, Andrew; Orange, Clare; Duthie, Fraser

doi:10.7759/cureus.11394

Cited by 4 publications

(6 citation statements)

References 27 publications

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“…38 Additionally, according to Ishii et al, the sensitivity and specificity of D2-40 immunostaining to detect lymphatic invasion and predict LNM in T1 colorectal cancer were 58% and 88%, respectively. 39 Therefore, D2-40 staining of preoperative biopsy specimens could effectively detect lymphatic invasion.…”

Section: Discussionmentioning

confidence: 99%

A Clinicopathological Feature-Based Nomogram for Predicting the Likelihood of D3 Lymph Node Metastasis in Right-Sided Colon Cancer Patients

Long

Feng

Wang

et al. 2022

Diseases of the Colon &Amp; Rectum

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BACKGROUND: Despite advancements in treating right-sided colon cancer patients, the ideal scope of lymphadenectomy remains controversial. OBJECTIVE: Our objective was to investigate the likelihood of D3 lymph node metastasis in right-sided colon cancer patients and develop a clinicopathological feature-based nomogram for D3 lymphadenectomy. DESIGN: We retrospectively analyzed 286 right-sided colon cancer patients who underwent D3 lymphadenectomy. The patients were divided into 2 groups based on whether D3 lymph node metastasis was positive. Then, univariable and multivariable logistic regression analyses were performed to obtain independent risk factors for predicting D3 lymph node metastasis. Moreover, we performed receiver operating characteristic curve analyses to evaluate the predictive power of the model. SETTING: This study was conducted at Nanfang Hospital of Southern Medical University in China. PATIENTS: A total of 286 consecutive patients who underwent right hemicolectomy and D3 lymphadenectomy as a primary treatment for right-sided colon cancer between January 2016 and December 2019 were enrolled in this study. MAIN OUTCOME MEASURES: The primary measures were independent risk factors for predicting D3 lymph node metastasis in right-sided colon cancer. RESULTS: The D3 lymph node metastasis rate in right-sided colon cancer patients was 16.1% (46/286). D3 lymphadenectasis on CT, lymphatic invasion, and T4 tumors were filtered out as independent risk factors for D3 lymph node metastasis according to the multivariable logistic regression analysis. We established a nomogram that predicted D3 lymph node metastasis of right-sided colon cancer on the combination of the 3 factors with an area under the curve of 0.717 (95% CI, 0.629–0.806). LIMITATIONS: This was a retrospective study from a single center. CONCLUSIONS: We developed a valuable clinicopathological feature-based nomogram to predict the incidence of D3 lymph node metastasis in right-sided colon cancer patients. Patients with D3 lymphadenectasis on CT, preoperative T4 tumors, and lymphatic invasion should undergo D3 lymphadenectomy. See Video Abstract at http://links.lww.com/DCR/B852. UN NOMOGRAMA BASADO EN CARACTERÍSTICAS CLÍNICO-PATOLÓGICAS PARA PREDECIR LA PROBABILIDAD DE METÁSTASIS EN GANGLIOS LINFÁTICOS D3 EN PACIENTES CON CÁNCER DE COLON DERECHO ANTECEDENTES: A pesar de los avances en el tratamiento de pacientes con cáncer de colon derecho, el ámbito ideal de la linfadenectomía sigue siendo controvertido. OBJETIVO: Investigar la probabilidad de metástasis en los ganglios linfáticos D3 en pacientes con cáncer de colon derecho y desarrollar un nomograma basado en características clínico-patológicas basado para la linfadenectomía D3. DISEÑO: Analizamos retrospectivamente a 286 pacientes con cáncer de colon derecho que se sometieron a linfadenectomía D3. Los pacientes se dividieron en dos grupos en función de si eran positivos para metástasis en los ganglios linfáticos D3. Luego, se realizaron análisis de regresión logística univar...

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Section: Discussionmentioning

confidence: 99%

A Clinicopathological Feature-Based Nomogram for Predicting the Likelihood of D3 Lymph Node Metastasis in Right-Sided Colon Cancer Patients

Long

Feng

Wang

et al. 2022

Diseases of the Colon &Amp; Rectum

View full text Add to dashboard Cite

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“…Goodarzi et al, who examined 100 colorectal polyp cancer patients for LVI by D2-40 immunostaining and routine histology, found that using lymphatic endothelial markers increased the LVI detection rate (D2-40 immunostaining, 23% vs. routine histology, 8%). [ 14 ] In another study by Lai et al, 49 of 220 stage II colon cancer patients (22.3%) were found to have LVI by D2-40 immunostaining, whereas conventional H&E staining identified only 22 cases (10.0%) [ 15 ]. Similarly, 24 of the 69 low-risk stage II colon cancer patients (34.78%) studied herein were diagnosed as having LVI after D2-40 immunostaining, although H&E staining indicated no sign of LVI.…”

Section: Discussionmentioning

confidence: 99%

“…Lai et al found that in stage II colon cancer, LVI positivity by D2-40 immunostaining was associated with a significantly increased risk of death (HR 2.457; 95% CI 2.032-4.652; P = 0.008), as compared to LVI positivity by H&E staining (HR 1.543; 95% CI, 0.876-1.992; P = 0.961). [ 15 ] Goodarzi et al investigated the presence of LVI by D2-40 immunostaining in 100 patients with colorectal polyp cancer and discovered that IHC-detected LVI was associated with worse disease-specific survival (HR, 14.07; 95% CI 1.57-125.97; P = 0.018) [ 14 ]. In our study, multivariate analysis demonstrated that a missed diagnosis of LVI by routine H&E staining in stage II colon cancer was significantly associated with adverse clinical outcomes, that is to say, reduced OS and DFS.…”

Section: Discussionmentioning

confidence: 99%

“…D2-40 is a monoclonal antibody against a 40-kDa O-linked transmembrane sialoglycoprotein podoplanin, a specific marker for lymphatic endothelial cells [12]. Several studies have reported that D2-40 immunostaining can increase the detection rate of LVI in colon cancer [13][14][15][16][17]. Furthermore, previous research has revealed an association between IHC-detected LVI and clinical relevance in other tumors (e.g., breast cancer and melanoma) [18][19][20].…”

Section: Introductionmentioning

confidence: 99%

“…In contrast, double immunostaining for CD34 and D2-40 led to LVI detection in 14 patients[13]. Goodarzi et al, who examined 100 colorectal polyp cancer patients for LVI by D2-40 immunostaining and routine histology, found that using lymphatic endothelial markers increased the LVI detection rate (D2-40 immunostaining, 23% vs. routine histology, 8%) [14]. In another study by Lai et al, 49 of 220 stage II colon cancer patients (22.3%) were found to have LVI by D2-40 immunostaining, whereas conventional H&E staining identified only 22 cases (10.0%)[15].…”

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Prognostic Significance of Lymphovascular Invasion Detected by D2-40 in Low-Risk Stage II Colon Cancer

Prugmahachaikul¹,

Sanpavat²

2021

Cureus

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Background Lymphovascular invasion (LVI) is included in the criteria of high-risk stage II colon cancer. However, there are limitations to detecting LVI by routine hematoxylin and eosin (H&E) staining. Alternatively, immunohistochemistry (IHC) for the lymphatic endothelial marker D2-40 may help detect LVI, but its prognostic significance remains unknown. This study aimed to evaluate the prognostic significance of LVI, detected by IHC for D2-40, in low-risk stage II colon cancer. Materials and Methods A total of 69 patients with low-risk stage II colon cancer were tested for D2-40 to assess LVI. Then, the relationships between IHC-detected LVI and clinical outcomes, including disease-free survival (DFS) and overall survival (OS), were analyzed using both univariate and multivariate analyses. Results IHC for D2-40 revealed that 24 out of the 69 cases (34.78%) had LVI-positive tumors. IHC-detected LVI was significantly associated with adverse clinical outcomes on univariate analysis, i.e., both reduced DFS (P = 0.002) and OS (P = 0.0163). In multivariate analysis, controlling for age, IHC-detected LVI remained a significant predictor of reduced DFS with a hazard ratio (HR) of 3.37 and a 95% confidence interval (CI) of 1.39-8.15 (P = 0.007) and OS (HR, 5.66; 95% CI, 1.02-31.51; P = 0.048). Conclusions Our results demonstrated that IHC analysis for D2-40 enhanced LVI detection in patients with low-risk stage II colon cancer and that cases with a missed diagnosis of LVI by routine H&E staining had adverse clinical outcomes, that is, reduced DFS and OS.

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Predictors of Nodal Disease in Rectal Cancer Patients with Complete Mucosal Response to Neoadjuvant Therapy

et al. 2023

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Background Some patients with locally advanced rectal cancer (LARC) achieve complete mucosal response following neoadjuvant therapy (NAT) and may be candidates for watch and wait strategy. This study aimed to identify predictors of nodal disease in patients with LARC who had a complete mucosal response to NAT. Methods This case–control study included patients with LARC who were treated with NAT in the National Cancer Database between 2004 and 2019. Patients with complete mucosal response, defined as pathologic T0, were identified and classified according to the status of the pathologic N stage into complete response (pT0, pN0) and complete mucosal response with positive nodal disease (pT0, pN +). The two groups were compared regarding baseline demographics and tumor characteristics to determine the predictors of nodal disease after NAT. Results A total of 5529 patients (59.7% male) with a mean age of 59.6 ± 12.2 years had a complete mucosal response following NAT. Nodal disease was detected in 443 (8%) patients with a complete mucosal response. Independent predictors of nodal disease were clinical N + stage (OR: 1.87, p < 0.001), mucinous histology (OR: 3.8, p = 0.003), and lymphovascular invasion (OR = 4.01, p < 0.001). The clinical T stage was inversely related to the risk of nodal disease. Conclusions Despite having a complete mucosal response following NAT, 8% of patients had nodal disease. Clinical evidence of nodal involvement on preoperative assessment, mucinous tumor histology, and lymphovascular invasion predicted nodal disease after NAT. These findings should be considered when making a decision on watch and wait strategy in patients with clinical complete response.

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The Detection of Lymphatic Invasion in Colorectal Polyp Cancer Using D2-40 Immunohistochemistry and Its Association With Prognosis

Cited by 4 publications

References 27 publications

A Clinicopathological Feature-Based Nomogram for Predicting the Likelihood of D3 Lymph Node Metastasis in Right-Sided Colon Cancer Patients

A Clinicopathological Feature-Based Nomogram for Predicting the Likelihood of D3 Lymph Node Metastasis in Right-Sided Colon Cancer Patients

Prognostic Significance of Lymphovascular Invasion Detected by D2-40 in Low-Risk Stage II Colon Cancer

Predictors of Nodal Disease in Rectal Cancer Patients with Complete Mucosal Response to Neoadjuvant Therapy

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