Histology of metastatic colorectal cancer in a lymph node

• Published in: PloS one 2023-04, Vol.18 (4), p.e0284536-e0284536
• Main Authors: Yokoyama, Shozo, Watanabe, Takashi, Fujita, Yoichi, Matsumura, Shuichi, Ueda, Katsuya, Nagano, Shotaro, Kinoshita, Ikuharu, Murakami, Daisuke, Tabata, Hirotaka, Tsuji, Toshiaki, Ozawa, Satoru, Tamaki, Takuya, Nakatani, Yoshihiro, Oka, Masami
• Format: Article
• Language: English
• Subjects: Adenocarcinoma; Adenocarcinoma - pathology; Biology and Life Sciences; Cancer; Cancer therapies; Care and treatment; Chemotherapy; Classification; Cloning; Colonic Neoplasms - pathology; Colorectal cancer; Colorectal carcinoma; Colorectal Neoplasms - pathology; Colorectal Neoplasms - surgery; Comparative analysis; Differentiation; Ethics; Heterogeneity; Histology; Humans; Lymph Node Excision; Lymph nodes; Lymph Nodes - pathology; Lymphatic Metastasis - pathology; Lymphatic system; Medical research; Medicine and Health Sciences; Medicine, Experimental; Metastases; Metastasis; Morphology; Neoplasm Staging; Patient outcomes; Phenotypes; Prognosis; Rectal Neoplasms - pathology; Retrospective Studies; Software; Tumors
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0284536

A primary colorectal cancer (CRC) tumor can contain heterogeneous cancer cells. As clones of cells with different properties metastasize to lymph nodes (LNs), they could show different morphologies. Cancer histologies in LNs of CRC remains to be described. Our study enrolled 318 consecutive patients with CRC who underwent primary tumor resection with lymph node dissection between January 2011 and June 2016. 119 (37.4%) patients who had metastatic LNs (mLNs) were finally included in this study. Cancer histologies in LNs were classified and compared with pathologically diagnosed differentiation in the primary lesion. The association between histologies in lymph node metastasis (LNM) and prognosis in patients with CRC was investigated. The histologies of the cancer cells in the mLNs were classified into four types: tubular, cribriform, poorly differentiated, and mucinous. Same degree of pathologically diagnosed differentiation in the primary tumor produced various histological types in LNM. In Kaplan-Meier analysis, prognosis was worse in CRC patients with moderately differentiated adenocarcinoma who had at least some mLN also showing cribriform carcinoma than for those whose mLNs all showed tubular carcinoma. Histology in LNM from CRC might indicate the heterogeneity and malignant phenotype of the disease.