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Arch Surg. 2010 Jan;145(1):12-7. doi: 10.1001/archsurg.2009.224.

Association between a high number of isolated lymph nodes in T1 to T4 N0M0 colorectal cancer and the microsatellite instability phenotype.

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  • 1Département Medico-Chirurgical de Pathologie Digestive, Assistance Publique des Hôpitaux de Paris, Hôpital Lariboisière, Université Paris, France.



Stage I or II colorectal carcinomas with microsatellite instability (MSI) are characterized by more isolated lymph nodes in the resected specimen than their counterparts with microsatellite stability (MSS).


Prospective study.


Academic research.


Using a pentaplex polymerase chain reaction assay, MSI status was determined prospectively for 135 operative patients.


Mismatch repair defects were investigated by immunohistochemistry on tumors demonstrating MSI.


Among 82 stage I or II colorectal carcinomas, 11 had MSI, and 71 had MSS, with a mean (SD) number of 23.6 (3.1) and 13.7 (1.0) negative lymph nodes, respectively (P = .001). The mean number of lymph nodes for all resected stage I or II colorectal carcinomas analyzed at our hospital was 15. The prevalence of MSI among tumors with more than 15 lymph nodes in the specimen was 25% (9 of 36), and 82% (9 of 11) of MSI tumors belonged to this group.


A high number of isolated lymph nodes in stage I or II colorectal carcinomas was associated with the MSI phenotype. Good prognosis that is usually associated with tumors having a high number of uninvolved lymph nodes might reflect the high prevalence of MSI among these tumors. The number of examined lymph nodes as a quality criterion should be used with caution. For stage I or stage II colorectal carcinomas, restricting MSI phenotyping to tumors with more than the mean number of lymph nodes identifies almost all MSI tumors.

[PubMed - indexed for MEDLINE]
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