Progress in evaluating the risk of lymph node metastasis in early colorectal cancer.
10.3760/cma.j.cn441530-20220819-00351
- VernacularTitle:早期结直肠癌的淋巴结转移风险评估体系的现状及研究进展
- Author:
Xin Yi ZHOU
1
;
Ke Feng DING
1
;
Jun LI
1
Author Information
1. Department of Colorectal Surgery and Oncology,Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education, Key Laboratory of Molecular Biology in Medical Sciences, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China Zhejiang Provincial Clinical Research Center for Cancer, Hangzhou 310058, China Cancer Center of Zhejiang University, Hangzhou 310058, China.
- Publication Type:Journal Article
- MeSH:
Humans;
Lymphatic Metastasis/pathology*;
Artificial Intelligence;
Colorectal Neoplasms/surgery*;
Risk Factors;
Risk Assessment;
Neoplasm Invasiveness;
Lymph Nodes/pathology*
- From:
Chinese Journal of Gastrointestinal Surgery
2023;26(5):492-498
- CountryChina
- Language:Chinese
-
Abstract:
Early colorectal cancers refer to invasive cancers that have infiltrated into the submucosa without invading muscularis propria, and approximately 10% of these patients have lymph node metastases that cannot be detected by conventional imaging. According to the guidelines of Chinese Society of Clinical Oncology (CSCO) Colorectal Cancer, early colorectal cancer cases with risk factors for lymph node metastasis (poor tumor differentiation, lymphovascular invasion, deep submucosal invasion and high-grade tumor budding) should receive salvage radical surgical resection; however, the specificity of this risk-stratification is inadequate, making most patients undergo unnecessary surgery. Firstly, this review focuses on the definition, oncological impact importance and controversy of the above "risk factors". Then, we introduce the progress of the risk stratification system for lymph node metastasis in early colorectal cancer, including the identification of new pathological risk factors, the construction of new risk quantitative models based on pathological risk factors, artificial intelligence and machine learning technology and the discovery of novel molecular markers associated with lymph node metastasis based on gene test or liquid biopsy. Aim to enhance clinicians' understanding of the risk assessment of lymph node metastasis in early colorectal cancer; we suggest to take the patient's personal situation, tumor location, anti-cancer intention and other factors into account to make individualized treatment strategies.
