New insights into the lymphovascular microanatomy of the colon and the risk of metastases in pT1 colorectal cancer obtained with quantitative methods and three‐dimensional digital reconstruction

• DOI: 10.1111/his.12639
• Publication Date: 2015-01-02T07:12:24Z
• Authors: Peter J Brown; Eu‐Wing Toh; Katherine J E Smith; Pamela Jones; Darren Treanor; Derek Magee; Dermot Burke; Phil Quirke
• Keywords: Lymphovascular invasion

Aims UK faecal occult blood test screening has tripled the proportion of pT1 colorectal cancers. The risk metastasis is predicted by depth invasion, suggesting that access to deep lymphovascular vessels important. aim this study was quantify distribution and size submucosal vasculature, generate a novel three‐dimensional (3D) model validate findings. Methods results Thirty samples normal large bowel wall were immunostained with CD 31, vascular endothelium marker, identify vessels, which quantified digitally analysed for their number, circumference, area diameter in mucosa submucosa (Sm1, Sm2, Sm3). required serial sections, double immunostain (using 31 D2‐40), 3D reconstruction. Significant differences shown between layers circumference ( P < 0.001). Blood most numerous (11.79 vessels/0.2 mm 2 ) but smaller [median 247 μm , interquartile range IQR 162–373 ] than where they fewer number (6.92 considerably larger (2086 1007–4784 ). generated observations on structures. Conclusions do not increase submucosa, as hypothesized. suggests we should investigate or volume invasion rather depth.