Mismatch repair system and p53 expression in patients with T1 and T2 colorectal cancer: predictive role of lymph node metastasis and survival.
BACKGROUND
The aim of this study was to evaluate the predictive role of the mismatch repair (MMR) system and p53 expression for lymph node metastasis and long-term survival in patients with T1 and T2 colorectal cancer.


METHODS
A total of 543 patients with T1 or T2 colorectal cancers who underwent radical surgery with regional lymphadenectomy from December 2007 to December 2009 were analyzed. Predictive factors for lymph node metastasis and prognostic factors were analyzed.


RESULTS
During the median follow-up period of 4 years, the 5-year disease-free survival rate for patients without lymph node metastasis was 94.8%, which was significantly higher than that for those with lymph node metastases (85.2%; P < 0.001). On multivariate analysis, gender, tumor location, N category, lymphatic invasion, vascular invasion, and perineural invasion were independent prognostic factors for disease-free survival; however MMR defect, p53 expression, and microsatellite instability (MSI) were not. The presence of lymphatic invasion, vascular invasion, and tumor budding were independent predictors of lymph node metastasis.


CONCLUSIONS
In patients with T1 or T2 colorectal cancer, lymphatic invasion, vascular invasion, and tumor budding were predictive of lymph node metastasis; however, MMR defect, p53 expression, and MSI were not predictive.
['Huh|Jung Wook|JW|', 'Kim|Hee Cheol|HC|', 'Kim|Seok Hyung|SH|', 'Park|Yoon Ah|YA|', 'Cho|Yong Beom|YB|', 'Yun|Seong Hyeon|SH|', 'Lee|Woo Yong|WY|', 'Chun|Ho-Kyung|HK|']
D000230:Adenocarcinoma D000328:Adult D000368:Aged D000369:Aged, 80 and over D014408:Biomarkers, Tumor D015179:Colorectal Neoplasms D053843:DNA Mismatch Repair D045643:DNA Repair Enzymes D005260:Female D005500:Follow-Up Studies D006801:Humans D007124:Immunoenzyme Techniques D008198:Lymph Nodes D008207:Lymphatic Metastasis D008297:Male D053842:Microsatellite Instability D008875:Middle Aged D009361:Neoplasm Invasiveness D009367:Neoplasm Staging D011379:Prognosis D011446:Prospective Studies D015996:Survival Rate D016159:Tumor Suppressor Protein p53
lymph node metastasis prognostic factor early colorectal cancer