Abstract
BackgroundTo determine the prognostic relevance of neuroendocrine differentiation in poorly differentiated colorectal cancer.MethodsThe clinicopathological features and survival of 70 patients with poorly differentiated colorectal cancer were analyzed retrospectively. Chromogranin A and synaptophysin were used as neuroendocrine markers. Patients were followed-up for more than 3 years or until death.ResultsOf these 70 patients, 36 showed neuroendocrine differentiation. In univariate prognostic analysis, the patients with lymph node metastasis (P < 0.001), advanced TNM stage (P < 0.001), and neuroendocrine differentiation (P = 0.003) tended to have a poor prognosis. However, only lymph node metastasis was associated with a poor prognosis in multivariate analysis (P < 0.001). Patients with neuroendocrine differentiation were associated with lymph node metastasis (P = 0.006).ConclusionsNeuroendocrine differentiation in poorly differentiated colorectal cancer was not a direct prognostic factor in these patients. Lymph node metastasis was a direct prognostic factor in these patients. Patients with neuroendocrine differentiation were associated with lymph node metastasis.
Highlights
To determine the prognostic relevance of neuroendocrine differentiation in poorly differentiated colorectal cancer
Neuroendocrine differentiation (NED)(+) tumors were assigned to three subgroups based on the presence of immunoreactive cells per highpower field (HPF): subgroup 1(SG1) had less than 10% immunoreactive cells of the total number of cells per HPF; subgroup 2(SG2) had 10–20% immunoreactive cells; subgroup 3(SG3) had more than 20% immunoreactive cells
According to the 2010 World Health Organization (WHO) classification, specimens with more than 30% immunoreactive cells were classified as mixed adenoneuroendocrine carcinoma (MANEC), and these patients were excluded from the study
Summary
To determine the prognostic relevance of neuroendocrine differentiation in poorly differentiated colorectal cancer. Neuroendocrine differentiation (NED) has been observed in cancers of several non-neuroendocrine organs, including the gastrointestinal tract. Many studies have evaluated the clinical prognostic value of NED in colorectal cancer (CRC). In the study by Mori et al [1], NED did not influence patient prognosis. Lloyd et al [2] showed that, in 289 patients, NED did not influence prognosis in moderately differentiated colorectal carcinomas. In recent years, studies have revealed that NED does influence patient prognosis. Bernick et al [3] studied 38 CRC patients with NED and found that the prognosis of these patients was poor.
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