Zanco Journal of Medical Sciences
Skip Navigation Links
Available Issues
Editorial Board
Information for Authors
Review Process
Links and Contacts
  Zanko J Med Sci:  Dec. 2017; 21 (3): 1840-1845

The relationship between lymph node metastasis and some clinicopathologic variables in mucinous and non mucinous colorectal adenocarcinoma

Jawhar T. Omer *, Tenya T. Abdulhameed *


* Department of Pathology, College of Medicine, Hawler Medical University, Erbil, Iraq.


Background and objective: Involvement of lymph nodes is an important prognostic factor in most cancers, including colorectal cancer in which lymph node status is the strongest pathologic predictor of patient outcome. This study aimed to find any relationship between lymph node metastasis and associated clinicopathologic variables in colorectal carcinoma.

Methods: In this retrospective study, 136 cases of colorectal cancer were reviewed from Rizgary Teaching Hospital and some private labs in Erbil, Kurdistan region, Iraq during the period between August 2010 and December 2015. All cases were surgically treated with total colectomy or hemi colectomy.

Results: A total of 136 cases of colorectal cancer were included in this study; 53% presented with one or more lymph node metastasis, 47% were between 40 and 60 years of age and 68% were male. There was no statistically significant relationship between lymph node status and any of the studied clinicopathologic variables. 

Conclusion: In colorectal adenocarcinoma, there was no statistically significant correlation between lymph node involvement and any of the studied clinicopathologic variables including tumor size, anatomic location, differentiation and histologic type, depth of invasion or patient gender and age.

Keywords: Colorectal; carcinoma; Lymph node; Metastasis.


1. Jemal A, Siegel R, Ward E, Hao YP, Xu JQ, Murray T, et al. Cancer Statistics. Cancer J Clin 2008; 58:71-96.

2. Soreide K, Janssen MAE, Soiland H, Korner H, Baak APJ. Microsatellite instability in colorectal cancer. Br J Surg 2006; 93:395-406.

3. Fujita S, Shimoda T, Yoshimura K, Yamamoto S, Akasu T, Moriya Y. Prospective evaluation of prognostic factors in patients with colorectal cancer undergoing curative resection. J SurgOncol 2003; 84: 127-31.

4. Kosmider S, Lipton L. Adjuvant therapies for colorectal cancer. World J Gastroenterol 2007; 13:3799-805.

5. Siriwardana PN, Hewavisenthi J, Deen KI. Histopathology reporting in colorectal cancer. Ceylon Med J 2006; 51:156-7.

6. Libutti SK, Saltz LB, Rustgi AK, Tepper JE. Cancer of colon. In: DeVita VT, Hellman S, Rosenberg SA. Cancer Principles and Practice of Oncology. 7th ed. Lippincott, Williams & Wilkins; 2005. pp. 1061-109.

7. Compton CC. Key Issues in Reporting Common Cancer Specimens. Problems in Pathologic Staging of Colon Cancer. Arch Pathol Lab Med 2006; 130:120-8.

8. Gospodarowicz M, Miller D, Groome PA. The process for continuous improvement of the TNM classification. Cancer 2004; 100:1-5.

9. Fania S, Wilma E, Peter J, Gijs A, Hans M, Geertruida H, et al. Detailed examination of lymph nodes improves prognostication in colorectal cancer. Int J Cancer 2010; 126:2644-52.

10. Sobin LH, Greene FL. TNM classification: clarification of number of regionallymph nodes for pNo. Cancer 2001; 92:452.

11. Wittekind CH, Wagner G. Colon and rectum. In: TNM-Classification of MalignantTumors. New York, NY: Springer; 1997. PP. 64-7.

12. Wu X, Chenb VW, Jim MJ, Roffers S, Groves FD, Correa CN, et al. Subsite-Specific Colorectal Cancer Incidence Rates and Stage Distributions among Asians and Pacific Islanders in the United States, 1995 to 1999. Cancer Epidemiol Biomarkers Prev 2004; 13 (7):1215-22.

13. World Health Organization. International histological classification of tumors. Volume 15 Histological typing of intestinal tumors. Geneva: World Health Organization; 1976.

14. Washington MK, Berlin J, Branton PA. Protocol for the examination of specimens from patients with primary carcinomas of the colon and rectum. Arch Pathol Lab Med 2008; 132:1182-93.

15. Edge S, Byrd DR, Carducci. AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer; 2009. P. 115.

16. Contu P, Contu S, Moreira L. Bcl-2 Expression In rectal Cancer. ArqGastroenterol 2006; 43(4):284-7.

17. Tenya TA, Salah AA. BCL2 and P53 immunoexpression in colorectal carcinoma. ZJMS 2014; 18(2):751-5.

18. Nasser R, Roshanak D, Seyed AM, Farhad Z, Ahad AV, Mitra M. The Relationship between Size of Adenocarcinoma of Colon and Lymph Node Involvement. Iran J Pathol 2011; 6(3):117-23.

19. Takahisa M, Masakatsu F, Toshio U, Masataka N, Yuichiro Y, Nozomu K, et al. Risk of lymph node metastasis in patients with pedunculated type early invasive colorectal cancer: A retrospective multicenter study. Cancer Sci 2011; 102(9):1693-7.

 20. Hye YS, Won KK, Sang WK, Kwan WN, Chan KJ, Jae HC, et al. Risk Factors for Lymph Node Metastasis in Patients with Submucosal Invasive Colorectal Carcinoma. Korean Surg 2010; 78:207-12.

21. Nabi U, Nagi A, Riaz S, Sami W. Morphological Evaluation of Colorectal Carcinoma with Grading Staging and Histological types. JPMA 2010; 60:998.

22. Chatlaa CH, Jhalaa N, Katkooria V, Alexanderb D, Melethc S, Grizzlea W, et al. Recurrence and survival predictive value of phenotypic expression of Bcl-2 varies with tumor stage of colorectal adenocarcinoma. Cancer Biomark 2005; 1(4-5): 241–50.

23. Ismail H, El-Baradie M, Moneer M, Khorshid O, Touny A. Clinico-Pathological and Prognostic Significance of p53, Bcl-2 and Her-2/neu Protein Markers in Colorectal Cancer Using Tissue Microarray. J Egyptian Nat Cancer Inst 2007; 19:3-14.

24. DemiRbaŠĻ£ S, Sücüllü I, Yildirim F, Çelenk T. Influence of the c-erb B-2, nm23, bcl-2 and p53 protein markers on colorectal cancer. Turk J Gastroenterol 2006; 17(1):13-9.

25. Steven S, Bisong X, Jae Y, Jijiang Z, Randoph B, Mary R. Number of Lymph Nodes Examined and Associated Clinicopathologic Factors in Colorectal Carcinoma. Arch Pathol Lab Med 2009; 133:781-6.

26. Bruno M, Janine R, Hans M, Tina S, Ines K, Claudio C, et al. The clinical significance of lymph node size in colon cancer. Modern Pathol 2012; 25:1413-22.

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Slightly know the replica watches uk fashionable women, even if you do not understand the replica watches also know that Cartier tanks, after all, this is the rolex replica royal family, film stars, literary celebrities, and rolex replica uk even political places are wearing watches.