Observational Study
Copyright ©The Author(s) 2017.
World J Gastroenterol. Aug 28, 2017; 23(32): 5936-5944
Published online Aug 28, 2017. doi: 10.3748/wjg.v23.i32.5936
Table 1 Univariate analysis of clinicopathological and histological parameters for lymph node metastasis
LNM
P value
No (n = 221)Yes (n = 31)
Age (yr)61.81 ± 11.4061.35 ± 10.630.8334
63.0 (31.0, 86.0)66.0 (38.0, 78.0)
Sex
Male115 (88.46)15 (11.54)0.7205
Female106 (86.89)16 (13.11)
Tumor location
Ascending colon34 (89.48)4 (10.52)0.6018
Transverse colon12 (85.71)2 (14.29)
Descending colon6 (100.00)0 (0.00)
Sigmoid colon73 (91.25)7 (8.75)
Rectosigmoid colon14 (93.33)1 (6.67)
Rectum78 (82.98)16 (17.02)
Cecum3 (75.00)1 (25.00)
Vermiform appendix1 (100.00)0 (0.00)
Tumor size (cm)2.05 ± 1.672.07 ± 1.270.6902
1.8 (0.2, 6.5)2.0 (0.4, 6.5)
Tumor type
Pedunculated type84 (93.33)6 (6.67)0.0424
Sessile type137 (84.57)25 (15.43)
Depth of submucosal invasion
by JSCCR (μm)2473.94 ± 2003.783777.42 ± 2167.100.0002
2200.0 (0.0, 13500.0)3500.0 (1050.0, 12000.0)
< 100046 (100.00)0 (0.00)0.0021
≥ 1000175 (84.95)31 (15.05)
by Kitajima (μm)1944.3 ± 1885.183380.65 ± 2390.280.0002
1900.0 (0.0, 13500.0)3000.0 (500.0, 12000.0)
< 100076 (95.00)4 (5.00)0.0218
≥ 1000145 (94.30)27 (15.70)
by Ueno (μm)2671 ± 1898.393908.06 ± 2147.170.0002
2300.0 (50.0, 13500.0)3500.0 (1050.0, 12000.0)
< 100034 (100.00)0 (0.00)0.0113
≥ 1000187 (85.78)31 (14.22)
Width of submucosal invasion (μm)5831.45 ± 4724.029261.29 ± 4692.03< 0.0001
5000.0 (50.0, 31000.0)8000.0 (1900.0, 21000.0)
< 4000 μm87 (96.67)3 (3.33)0.0010
≥ 4000 μm134 (82.72)28 (17.28)
Depth multiplied by width
by JSCCR (mm2)20.22 ± 35.0738.91 ± 36.50< 0.0001
11.6 (0.0, 303.8)26.6 (2.0, 163.8)
< 6.584 (98.82)1 (1.18)< 0.0001
≥ 6.5137 (82.04)30 (17.96)
by Kitajima (mm2)16.79 ± 34.5236.42 ± 37.97< 0.0001
8.8 (0.0, 303.8)23.1 (2.0, 163.8)
< 6.5100 (95.24)5 (4.76)0.0017
≥ 6.5121 (82.31)26 (17.69)
by Ueno (mm2)20.91 ± 34.8240.12 ± 36.52< 0.0001
12.8 (0.0, 303.8)26.6 (2.0, 163.8)
< 6.576 (98.70)1 (1.30)0.0001
≥ 6.5145 (82.86)30 (17.14)
Tumor differentiation
Well and moderately211 (87.92)29 (12.08)0.6470
Poorly10 (83.33)2 (16.67)
Lymphatic invasion
No190 (95.96)8 (4.04)< 0.0001
Yes31 (57.41)23 (42.59)
Venous invasion
No215 (87.76)30 (12.24)1.0000
Yes6 (85.71)1 (14.29)
Perineural invasion
No219 (87.60)31 (12.40)1.0000
Yes2 (100)0 (0.00)
Inflammation
No100 (87.72)14 (12.28)1.0000
Yes121 (87.68)17 (12.32)
Desmoplasia
No106 (92.17)9 (7.83)0.0550
Yes115 (83.94)22 (16.06)
Tumor budding
Ueno
Grade 0, 1158 (95.18)8 (4.82)< 0.0001
Grade 2, 363 (73.26)23 (26.74)
Present or absent
No119 (100)0 (0.00)< 0.0001
Yes102 (76.69)31 (23.31)
PDCs
No110 (100.00)0 (0.00)< 0.0001
Yes111 (78.17)31 (21.83)
Table 2 Predictive powers of histopathological factors for lymph node metastasis
SensitivitySpecificityAccuracyPositive P valueNegative P value
Depth of submucosal invasion
by JSCCR100.00%20.81%30.56%15.05%100.00%
by Kitajima87.10%34.39%40.87%15.70%95.00%
by Ueno100.00%15.38%25.79%14.22%100.00%
Width of submucosal invasion90.32%39.37%45.63%17.28%96.67%
Depth multiplied by width
by JSCCR96.77%38.01%45.24%17.96%98.82%
by Kitajima83.87%45.25%50.00%17.69%95.24%
by Ueno96.77%34.39%42.06%17.14%98.70%
Lymphatic invasion74.19%85.97%84.52%42.59%95.96%
Tumor budding
by Ueno74.19%71.49%71.83%26.74%95.18%
Present or absent100.00%53.84%59.52%23.31%100.00%
PDCs100.00%49.77%55.95%21.83%100.00%
Table 3 Comparison of histopathological factors for predicting of lymph node metastasis by multivariate analysis
ModelAUCSE95%CIDifference AUC95%CIP value
Crude (unadjusted)0.6400.046(0.549, 0.730)
JSCCR (depth)0.6660.041(0.585, 0.747)0.026(0.009, 0.043)0.0022
Kitajima (depth)0.6500.044(0.565, 0.736)0.011(-0.022, 0.043)0.5103
Ueno (depth)0.6640.042(0.582, 0.746)0.024(0.009, 0.040)0.0024
Width0.6920.040(0.613, 0.771)0.053(-0.007, 0.112)0.0829
JSCCR (depth × width)0.7030.038(0.629, 0.776)0.063(0.024, 0.103)0.0017
Kitajima (depth × width)0.6810.042(0.599, 0.763)0.042(-0.002, 0.085)0.0612
Ueno (depth × width)0.6990.038(0.624, 0.775)0.060(0.020, 0.099)0.0030
Budding (ueno)0.7680.044(0.682, 0.853)0.128(0.043, 0.214)0.0033
Lymphatic invasion0.8430.041(0.763, 0.924)0.204(0.114, 0.294)< 0.0001
Budding present itself0.8300.0277(0.776, 0.884)0.190(0.106, 0.274)< 0.0001
PDCs0.8110.0296(0.753, 0.870)0.172(0.087, 0.256)< 0.0001