Objective criteria for crohn-like lymphoid reaction in colorectal cancer

We aimed to determine semiquantitative evaluation criteria for Crohn-like lymphoid reaction (CLR). We reviewed 1,032 patients with colorectal cancer and evaluated CLR by counting all peritumoral lymphoid aggregates (LAs) and by measuring the maximum diameter of the largest LA. The maximum diameter o...

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Bibliographic Details
Published in:American journal of clinical pathology 2013-04, Vol.139 (4), p.434-441
Main Authors: Ueno, Hideki, Hashiguchi, Yojiro, Shimazaki, Hideyuki, Shinto, Eiji, Kajiwara, Yoshiki, Nakanishi, Kuniaki, Kato, Kei, Maekawa, Kazuya, Miyai, Kosuke, Nakamura, Takahiro, Yamamoto, Junji, Hase, Kazuo
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Colorectal cancer
Colorectal Neoplasms - immunology
Colorectal Neoplasms - mortality
Colorectal Neoplasms - pathology
Female
Humans
Immunohistochemistry
Kaplan-Meier Estimate
Lymphocytes, Tumor-Infiltrating - immunology
Male
Middle Aged
Prognosis
Proportional Hazards Models
Young Adult
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Summary:We aimed to determine semiquantitative evaluation criteria for Crohn-like lymphoid reaction (CLR). We reviewed 1,032 patients with colorectal cancer and evaluated CLR by counting all peritumoral lymphoid aggregates (LAs) and by measuring the maximum diameter of the largest LA. The maximum diameter of the largest LA, rather than the number, had a significant impact on survival. Active CLR determined by the 1-mm rule was significantly associated with MLH1/MSH2 immunohistochemical staining deficiency. The group with LAs 1 mm or larger had lower recurrence (P = .0008) and a higher survival rate (P < .0001) than that without LAs 1 mm or larger. These results were similarly observed in another cohort of 500 patients with colorectal cancer. The k values for CLR evaluation among 8 observers were 0.67 for the 1-mm rule and 0.50 for Graham's criteria. The size of the largest LA best reflects the specific characteristics of CLR, and the 1-mm rule is expected to improve assessment reproducibility.
ISSN:0002-9173
1943-7722
DOI:10.1309/ajcpwhueftgbwke4