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  • Title: [The significance of elastic staining in detecting vascular invasion in colorectal carcinoma].
    Author: Bogner B, Hegedûs G.
    Journal: Magy Onkol; 2009 Jun; 53(2):107-13. PubMed ID: 19581176.
    Abstract:
    Venous invasion (VI) is one of the most important prognostic factors in colorectal carcinomas (CRC). The interobserver variation of this feature varies between 10% and 89.5%, mainly due to the specimen processing and staining. VI was assessed using haematoxylin and eosin (H+E) alone in 611 cases and with elastic stain (orcein-haematoxylin) in 243 CRCs. The stage, the pattern of invasion and the presence of intramural and extramural VI were determined. VI was identified in 27.45% of the H+E stained sections and in 67.1% using elastic stain counterstained with haematoxylin. The incidence of VI proved stage dependent as it has been noted in 13% of Dukes A, 36% of Dukes B, 80% of Dukes C and in 83% of CRCs with distant metastasis. The pattern of invasion is strongly connected to the VI, accordingly, VI could be identified in 82% of CRCs with invasive and only in 44% with expansive margin. The use of elastic stain did not help in differentiation of extramural tumour deposits due to the damage of elastic membranes in the vascular walls and the presence of elastic fibres in the lymph node capsule. As a conclusion, the routine use of elastic stains in our practice doubled the identification of VI. The frequency of VI depends on the stage and pattern of invasion in CRCs. As it is more likely to occur in the advanced CRCs, the use of elastic stain is even more suggested in Dukes B carcinomas with invasive margin.
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