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New research · Pathology
Virchows Archiv : an international journal of pathology · 1w
Cohort studyVirchows Archiv : an international journal of pathology · 2026

Clinicopathological features and risk stratification for lymph node metastasis in early-stage colorectal cancer (from intramucosal carcinoma to SM2): a large-scale retrospective study based on a Chinese population.

Minying Deng, Ayizimugu Abuduwaili, Jiamei Wu … Yingyong Hou
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PathologyCohort study

Deeper SM2 submucosal invasion linked to highest lymph node spread in early colorectal cancer

Clinicopathological features and risk stratification for lymph node metastasis in early-stage colorectal cancer (from intramucosal carcinoma to SM2): a large-scale retrospective study based on a Chinese population.

Minying Deng … Yingyong Hou
Virchows Archiv : an international journal of pathology · 2026
Purpose

To analyze clinicopathological features and lymph node metastasis (lymph node metastasis) risk factors in early-stage colorectal cancer (CRC, ranging from intramucosal carcinoma to SM2) in Chinese patients, with a focus on stratifying SM2 tumors into low- and high- risk groups based on cumulative pathological factors, and to optimize treatment strategies for SM1/SM2 subgroups.

Methods

A retrospective study included 1693 patients with early-stage CRC (2010-2019) from Zhongshan Hospital, Fudan University.

n = 1693 patients
Results

about 1 in 6 with the deepest submucosal invasion had cancer in nearby lymph nodes

0.9%
Intramucosal
2.6%
SM1a/b
4.5%
SM1c
15.6%
SM2
More results

Lymph node metastasis rates increased with cumulative adverse indicators (0-4 indicators: 4.4%、11.8%、17.0%、27.1%、30.3%; P < 0.001).

In the SM2 subgroup, high-grade histology and lymphovascular invasion were independent risk factors.

More results

Notably, SM2 patients with ≥ 2 risk factors (high-grade histology / lymphovascular invasion / intermediate and high-grade tumor budding) had significantly higher lymph node metastasis rates (20.5%-33.3%) (P < 0.05), whereas SM1 tumors could not be further stratified.

“
Conclusion

External validation is needed before clinical application.

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