Lymphovascular (LVI) and Perineural Invasion (PNI) in Colorectal Carcinoma and Their Association with Tumor Stages: A Retrospective Study on 250 Cases in Bangabandhu Sheikh Mujib Medical University

Author(s): Mohammad Zillur Rahman, Mohammad Shukur Ali, Syeda Rumman Aktar Siddiqui

Introduction: Colorectal cancer (CRC) is the most prevalent type of cancer and ranks as the fifth leading cause of cancer-related death. Despite advancements in technology and treatment, recurrence and metastases continue to be significant issues, leading to decreased patients’ survival. Lymphovascular invasion (LVI) involves small lymphatic or blood (typically venous) vessels within the tumor, while perineural invasion (PNI) is the tumor invasion of the perineural sheath or epineurium. LVI and PNI may be the significant indicators for CRC prognosis and progression. This paper aimed to determine the association between lymphovascular invasion (LVI) and perineural invasion (PNI) with the tumor stages of colorectal carcinoma.

Methods: This retrospective cross-sectional descriptive type of study was conducted at the Department of Pathology in Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh during January, 2024 to June, 2024. A consecutive sampling technique was used and a series of 250 excised cases of colorectal carcinoma irrespective of age and sex were retrospectively enrolled in this study. The data were analyzed using Statistical Package for Social Sciences (SPSS) software, version-23.0.

Results: A series of 250 excised cases of colorectal carcinoma irrespective of age and sex were enrolled in this study. The mean age of the patients was 47.89±15.71 years. Most cases (143, 57.20%) were males. Ascending colon was the most frequent (74, 29.6%) site of the growth of colorectal carcinoma.The most frequent histologic type of colorectal carcinoma was found to be adenocarcinoma NOS 203(81.2%). The most frequent histological grade was marked as low grade (207, 82.8%). Among the stages of pT, the most frequent stage was identified as pT3 (153, 61.2%) and among pN, the most frequent stage was found to be pN0 (140, 56%). The lymphovascular invasion (LVI) and perineural invasion (PNI) were significantly associated with the tumour stages of colorectal carcinoma (p= <0.001).

Conclusion: In conclusion, this study provides valuable insights into the clinicopathological characteristics of CRC in Bangladeshi patients. Lymphovascular invasion (LVI) and perineural invasion (PNI) were significantly associated with tumor stages of colorectal carcinoma which indicates LVI and PNI are the significant prognostic indicators of the CRC disease progression and prognosis

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