The lymphatic infiltration identified by D2-40 monoclonal antibody predicts lymph node metastasis in submucosal invasive colorectal cancer.

Abstract

BACKGROUND AND STUDY AIMS:

Lymphatic infiltration has been recognized as a significant risk factor for lymph node metastasis of submucosal invasive colorectal cancer (SICC), but it is difficult to detect microscopically on hematoxylin and eosin (H&E)-stained slides. We therefore identified lymphatic infiltration of tumor cells with D2-40 monoclonal antibody, which reacts specifically against the endothelium of lymphatic vessels, to make an objective and precise diagnosis.

PATIENTS AND METHODS:

The surgical specimens of 122 consecutive patients with nonpedunculated SICC were examined for lymphatic infiltration by immunohistochemical staining with D2-40 monoclonal antibody (LI-D) and for venous infiltration by Elastica van Gieson staining (VI-E).

RESULTS:

Lymph node metastasis was found in 20 patients. Multivariate analysis showed that LI-D (p = 0.0415) and VI-E (p = 0.0119) were significant risk factors for lymph node metastasis. Regardless of the presence of risk factors including at least either lymphatic infiltration or venous infiltration, no lymph node metastasis-positive patients were found (0%) among the 25 patients whose colorectal cancer had a submucosal invasive depth of less than 1,500 microm. No lymph node metastasis was found in any of the patients with a depth of submucosal invasion of less than 3,000 microm, who had no risk factors, including LI-D or VI-E.

CONCLUSIONS:

Correct evaluation of lymphatic infiltration by immunohistochemical staining with D2-40 monoclonal antibody may play a crucial role in determining whether there are indications for additional treatment in the management of endoscopically resected SICC.

• Authors: Ken Kawaura, Satoshi Fujii, Yukinori Murata, Takahiro Hasebe, Genichiro Ishii, Tohru Itoh, Yasushi Sano, Norio Saito, Atsushi Ochiai
• Journal: Pathobiology : journal of immunopathology, molecular and cellular biology (Pathobiology) Vol. 74 Issue 6 Pg. 328-35 ( 2007) ISSN: 1423-0291 [Electronic] Switzerland
• PMID: 18087197 (Publication Type: Journal Article)
• Copyright: (c) 2007 S. Karger AG, Basel.

Chemical References

• Antibodies, Monoclonal
• Antibodies, Monoclonal, Murine-Derived
• monoclonal antibody D2-40

Topics

• Adenocarcinoma (pathology)
• Adult
• Aged
• Aged, 80 and over
• Antibodies, Monoclonal
• Antibodies, Monoclonal, Murine-Derived
• Colorectal Neoplasms (pathology)
• Female
• Humans
• Immunohistochemistry
• Intestinal Mucosa (pathology)
• Lymphatic Metastasis (diagnosis)
• Lymphatic Vessels (pathology)
• Male
• Middle Aged
• Risk Factors