Evaluation of Prognostic Significance of Micropapillary Component in Colorectal Carcinoma

Abstract

Background: Micropapillary carcinoma (MP)has been described in several organs as an aggressive variant where it is associated with frequent lymphovascular invasion and poor clinical outcome. AIM: To classify colorectal carcinoma based on presence or absence of Micropapillary component and to evaluate the prognostic significance of Micropapillary pattern in colorectal carcinoma. Settings and Design: The study was undertaken on samples received at the Department of Pathology from 2003-2005. Materials and Methods: 100 cases of colorectal carcinoma with 43 cases showing micropapillary component were noted. The following parameters were assessed, histological grade, peritumoral lymphocytic infiltration, lymphovascular invasion, perineural invasion, tumorbudding, lymph node metastasis, distantmetastasis, depth of invasion, and TNM staging. Statistical analysis used was Fisher's exact test. Results: Colorectal carcinoma with micropapillary component was associated with high- grademorphology, with increased peritumoral lymphocytic infiltration, lymphovascularinvasion, perineuralinvasion, tumorbudding, lymph node metastasis and distant metastasis in comparison with colorectal carcinoma without micropapillary component. Conclusion: The diagnosis of patients with micropapillary component would be valuable in identifying high risk patients in TNM stages I and II .Colorectal carcinoma with micropapillary carcinoma differs from carcinoma without micropapillary component by shorter survival time in TNM stages I and II, more lymph node metastasis, distant metastasis, more aggressive behavior and lower differentiation status.