Pathological Diagnosis of Submucosal Invasive Colorectal Carcinoma (pT1 Colorectal Cancer): Overview of Histopathological and Molecular Markers to Predict Lymph Node Metastasis of Submucosal Invasive Colorectal Cancer

  • Tamotsu SugaiEmail author


We evaluated the risk of lymph node metastasis of submucosal invasive colorectal cancer (SICRC). Determining a need for subsequent treatment after endoscopic resection of SICRC is critical. Here we describe histopathological and biological risk factors for lymph node metastasis (LNM) in patients with SICRC. Histopathological predictors of LNM of SICRC traditionally include submucosal invasion depth (>1000 μm), unfavorable histology (poorly differentiated adenocarcinoma), lymphovascular invasion, and tumor budding. Recently, poorly differentiated clusters were shown to have value as a LNM marker in SICRC, in no way inferior to that of tumor budding. However, these histopathological factors cannot prevent overtreatment. Although a combination of histopathological factors has been used to predict LNM of SICRC, excellent results have not been obtained. Recently, several biomarkers predictive of LNM of SICRC were proposed, including microRNAs (e.g., miR32, miR181B, miR193B, miR195, miR411, miR100, and miR125b), and somatic copy number alterations closely associated with tumor invasion and metastasis, although the latter is a complex method used for LNM detection. A recent study showed that cancer-associated fibroblasts and epithelial–mesenchymal transition, which play major roles in cancer invasion, are potential predictors of LNM of SICRC. More creative indicators of LNM are needed.


Biomarker Cancer-associated fibroblasts Epithelial Mesenchymal transition Submucosal invasive colorectal cancer Tumor budding 


Conflict of Interest

We declare no conflicts of interest.


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© Springer Nature Singapore Pte Ltd. 2020

Authors and Affiliations

  1. 1.Department of Molecular Diagnostic PathologySchool of Medicine, Iwate Medical UniversityMoriokaJapan

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