Routine Elastin Staining in Surgically Resected Colorectal Cancer: Impact on Venous Invasion Detection and its Association With Oncologic Outcomes.
Adult
Aged
Aged, 80 and over
Azo Compounds
Biomarkers, Tumor
Biopsy
Colectomy
Colorectal Neoplasms
/ chemistry
Coloring Agents
Elastin
/ analysis
Eosine Yellowish-(YS)
Female
Humans
Male
Methyl Green
Middle Aged
Neoplasm Invasiveness
Predictive Value of Tests
Risk Assessment
Risk Factors
Staining and Labeling
Treatment Outcome
Veins
/ chemistry
Young Adult
Journal
The American journal of surgical pathology
ISSN: 1532-0979
Titre abrégé: Am J Surg Pathol
Pays: United States
ID NLM: 7707904
Informations de publication
Date de publication:
01 02 2022
01 02 2022
Historique:
pubmed:
20
8
2021
medline:
15
2
2022
entrez:
19
8
2021
Statut:
ppublish
Résumé
Venous invasion (VI) is a powerful yet underreported prognostic factor in colorectal cancer (CRC). Its detection can be improved with an elastin stain. We evaluated the impact of routine elastin staining on VI detection in resected CRC and its relationship with oncologic outcomes. Pathology reports from the year before (n=145) and the year following (n=128) the implementation of routine elastin staining at our institution were reviewed for established prognostic factors, including VI. A second review, using elastin stains, documented the presence/absence, location, number, and size of VI foci. The relationship between VI and oncologic outcomes was evaluated for original and review assessments. VI detection rates increased from 21% to 45% following implementation of routine elastin staining (odds ratio [OR]=3.1; 95% confidence interval [CI]: 1.8-5.3; P<0.0001). The second review revealed a lower VI miss rate postimplementation than preimplementation (22% vs. 48%, respectively; P=0.007); this difference was even greater for extramural VI-positive cases (9% vs. 38%, respectively; P=0.0003). Missed VI cases postimplementation had fewer VI foci per missed case (P=0.02) and a trend towards less extramural VI than those missed preimplementation. VI assessed with an elastin stain was significantly associated with recurrence-free survival (P=0.003), and cancer-specific survival (P=0.01) in contrast to VI assessed on hematoxylin and eosin alone (P=0.053 and 0.1, respectively). The association between VI and hematogenous metastasis was far stronger for elastin-detected VI (OR=11.5; 95% CI: 3.4-37.1; P<0.0001) than for hematoxylin and eosin-detected VI (OR=3.7; 95% CI: 1.4-9.9; P=0.01). Routine elastin staining enhances VI detection and its ability to stratify risk in CRC and should be considered for evaluation of CRC resection specimens.
Identifiants
pubmed: 34411028
doi: 10.1097/PAS.0000000000001790
pii: 00000478-202202000-00006
doi:
Substances chimiques
Azo Compounds
0
Biomarkers, Tumor
0
Coloring Agents
0
ELN protein, human
0
trichrome stain
0
Methyl Green
82-94-0
Elastin
9007-58-3
Eosine Yellowish-(YS)
TDQ283MPCW
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
200-212Informations de copyright
Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
Conflicts of Interest and Source of Funding: The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article.
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