Carcinoma Cells at Deeply Infiltrated Sites: Role in Development of Metastases in Patients with Advanced Colorectal Adenocarcinomas

  • Kiyomi Taniyama
  • Naomi Sasaki
  • Hiroshi Maruyama
  • Hayao Nakai
  • Hirofumi Nakatsuka
  • Kazushige Toyama
  • Eiichi Tahara


Carcinoma cells that infiltrate beyond the muscularis propria (“ss” lesions) have a significant role in developing metastases in patients with advanced colorectal carcinoma. Examination of 363 resected colon carcinomas revealed a high frequency of metastasis when carcinoma cells invaded beyond the muscularis propria. The metastases found in 170 patients with advanced colorectal adenocarcinomas invading this tissue were divided into five groups according to the histology of the ss lesions and the overall predominant histology. Lymph node metastasis was significantly increased as the histologic grade of the ss lesion decreased. Poorly differentiated adenocarcinoma cells were rapidly infiltrative regardless of the proliferative state and were associated with peritoneal dissemination, distant metastasis, or local recurrence. In contrast, moderately differentiated adenocarcinoma cells were more proliferative with reduced expression of E-cadherin compared to well differentiated adenocarcinoma; they were closely associated with liver metastasis and overexpression of p53. In the DNA ploidy study, there was a relation between decreased histologic differentiation and an increased likelihood of changes of the DNA ploidy pattern. Overexpression of α2β1- and α4β1-integrins of carcinoma cells preceded disruption of the cadherin system, which was associated with the morphologic change, and were correlated with the high metastatic properties of the carcinoma cells. Tumor classification based on histology in the ss is a good indicator of metastasis or prognosis of advanced colorectal adenocarcinomas. Further study based on these findings will facilitate understanding of the metastasis.


Liver Metastasis Colorectal Carcinoma Proliferate Cell Nuclear Antigen Muscularis Propria Colorectal Adenocarcinoma 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer Japan 1997

Authors and Affiliations

  • Kiyomi Taniyama
    • 1
  • Naomi Sasaki
    • 1
  • Hiroshi Maruyama
    • 2
  • Hayao Nakai
    • 2
  • Hirofumi Nakatsuka
    • 3
  • Kazushige Toyama
    • 4
  • Eiichi Tahara
    • 5
  1. 1.Department of Clinical PathologyKure Kyosai HospitalKure, Hiroshima 737Japan
  2. 2.Department of SurgeryKure Kyosai HospitalKure, Hiroshima 737Japan
  3. 3.Department of SurgeryKure City Medical Association HospitalKure, Hiroshima 737Japan
  4. 4.Department of SurgeryShizuoka General HospitalShizuoka 420Japan
  5. 5.First Department of PathologyHiroshima University School of MedicineMinami-ku, Hiroshima 734Japan

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