Assessment of new pathological markers in early stage colon cancer: Insights and limitations.

Abstract

Background: The decision to administer adjuvant chemotherapy to patients with local stage depends on specific high-risk features that are T4 tumor stage, presence of perineural invasion, lymphovascular invasion, poorly differentiated tumor histology, inadequate lymph node sampling (fewer than 12 lymph nodes), and evidence of tumor perforation or obstruction. Tumor-stroma ratio, tumor infiltrating lymphocytes (TIL), Crohn-like reaction (CLR), desmoid reaction, poorly differentiated clusters (PDC) are new pathological markers that are being studied.

Aim: To examine the relationship between new pathological markers and defined high risk factors, in early stage colorectal cancer.

Methods: We evaluated 155 patients with the diagnosis stage I and II colorectal cancer between the years 2007 and 2021 who were treated at Trakya University Hospital, Department of Medical Oncology. We divided those with and without high-risk factors into two groups. We examined the relationship of new pathological markers with these groups and with pathological markers in risk factors.

Results: There was no statistically significant correlation between presence of TIL, presence of PDC, presence of tumor budding, presence of CLR, presence of desmoid reaction and low and high-risk groups according to the degree of those with PDC (P = 0.82, P = 0.51, P = 0.77, P = 0.37, P = 0.83, respectively). In addition, no statistically significant correlation was found between the tumor-stroma ratio and low and high risk groups (P = 0.80). We found a statistically significant correlation between the presence of PDC and the presence of PDC grade 3 and T stage (P = 0.001, P = 0.001, respectively). It was determined that the presence of PDC and the frequency of grade 3 PDC increased with the advanced T stage.

Conclusion: No relationship was found between the presence of new pathological markers and high-low risk groups. When we examined the relationship between new and old pathological markers, only the frequency of detection of PDC and PDC grade 3 was found to be correlated with advanced T stage.