Document Detail

Retrospective evaluation of elastic stain in the assessment of serosal invasion of pT3N0 colorectal cancers.
MedLine Citation:
PMID:  23774172     Owner:  NLM     Status:  MEDLINE    
Peritoneal involvement is an important adverse prognostic factor in colorectal cancer (CRC) and determines a shift in the pathologic tumor node metastasis stage. Because peritoneal involvement is difficult to identify, use of special stains highlighting the peritoneal elastic lamina and mesothelial surface has been proposed. This study aims to determine whether use of elastic stain or CK7 immunohistochemistry on a single tissue section can refine the level of tumor invasion and determine whether restaging based on this assessment has prognostic significance in pT3N0 CRCs. Elastic stains were applied to 1 block per case from 244 consecutively resected pT3N0M0 CRCs. CK7 was evaluated in a 169-case subset. The elastic lamina was identified in only 101 cases (41%). Of those, 60 cases (24.6%) displayed elastic lamina invasion (ELI). This finding was associated with significantly worse (P<0.001) disease-free survival (DFS) (5-y DFS=60%) and significantly worse (P=0.01) overall survival (OS) (5-y OS=66.7%) compared with patients with no ELI (5-y DFS=87.8%, OS=92.7%) and those for whom no elastic lamina was identified (5-y DFS=82.5%, OS=86.0%). CK7 staining highlighted mesothelial cells in only 27 of 169 cases tested and helped demonstrate serosal invasion in only 5 cases (3%). In summary, the use of a single elastic stain is a useful and inexpensive method to demonstrate peritoneal involvement by tumor and should be considered for routine use in all pT3N0 CRCs. As tumors with ELI have an adverse prognosis, we propose that they should be upstaged compared with pT3N0 tumors without ELI.
Wen-Yih Liang; Wei-Chin Chang; Chih-Yi Hsu; Thomas Arnason; David Berger; Alexander T Hawkins; Patricia Sylla; Gregory Y Lauwers
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of surgical pathology     Volume:  37     ISSN:  1532-0979     ISO Abbreviation:  Am. J. Surg. Pathol.     Publication Date:  2013 Oct 
Date Detail:
Created Date:  2013-09-12     Completed Date:  2013-11-04     Revised Date:  2014-02-07    
Medline Journal Info:
Nlm Unique ID:  7707904     Medline TA:  Am J Surg Pathol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1565-70     Citation Subset:  IM    
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MeSH Terms
Aged, 80 and over
Colorectal Neoplasms / metabolism,  mortality,  pathology*
Elastic Tissue / pathology*
Kaplan-Meier Estimate
Middle Aged
Neoplasm Metastasis / diagnosis*
Neoplasm Staging / methods*
Retrospective Studies
Staining and Labeling / methods
Young Adult
Grant Support
Comment In:
Am J Surg Pathol. 2014 Jan;38(1):144-5   [PMID:  24335645 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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