Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Pathology

Materials and Methods : 60 cases of archived paraffin blocks of T3 and T4a CRC were tested for D2-40 expression by immunohistochemistry using a monoclonal antibody against against podoplanin to detect lymphovascular invasion. The T3 CRC cases (40 cases) were also stained by Verhoeff{u2019}s stain to detect peritoneal elastic lamina invasion.Results: Peritoneal elastic lamina invasion was identified in 40% (16 of 40) of the pT3 CRCs. PELI was significally correlated with lymph node metastasis (P = 0.001), lymphovascular invasion (P = .011), distant metatasis (P = .036), Dukes{u2019} & TNM tumor stage and D2-40 detected LVI (P < 0.001) but did not show significant difference among patient age, sex and tumor size, location, gross pattern, histologic type & grade and presence of necrosis, peritoneal nodules, perineural invasion & extramural vascular invasion. Lymphovascular invasion as highlighted by D2-40 immunohistochemistry was observed in half of CRC studied cases. Thirteen percent more cases with lymphatic vessel invasion could be identified compared to routine HE staining. Lymphovascular invasion as detected by D2-40 immunohistochemistry in studied cases were associated significantly with lymph node metastasis (P = 0.008), lymphovascular invasion (P = 0.009), peritoneal nodules (P = 0.023), perineural invasion (P = 0.008), distant metastasis (P = 0.038) and Dukes{u2019} & TNM tumor stage (P = .008) & (P < .01), respectively

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