TY - JOUR T1 - ASsociation between a high number of isolated lymph nodes in t1 to t4 n0m0 colorectal cancer and the microsatellite instability phenotype AU - Eveno C, Nemeth J, Soliman H, et al Y1 - 2010/01/01 N1 - 10.1001/archsurg.2009.224 JO - Archives of Surgery SP - 12 EP - 17 VL - 145 IS - 1 N2 - Hypothesis  Stage I or II colorectal carcinomas with microsatellite instability (MSI) are characterized by more isolated lymph nodes in the resected specimen than their counterparts with microsatellite stability (MSS).Design  Prospective study.Setting  Academic research.Patients  Using a pentaplex polymerase chain reaction assay, MSI status was determined prospectively for 135 operative patients.Main Outcome Measures  Mismatch repair defects were investigated by immunohistochemistry on tumors demonstrating MSI.Results  Among 82 stage I or II colorectal carcinomas, 11 had MSI, and 71 had MSS, with a mean (SD) number of 23.6 (3.1) and 13.7 (1.0) negative lymph nodes, respectively (P = .001). The mean number of lymph nodes for all resected stage I or II colorectal carcinomas analyzed at our hospital was 15. The prevalence of MSI among tumors with more than 15 lymph nodes in the specimen was 25% (9 of 36), and 82% (9 of 11) of MSI tumors belonged to this group.Conclusions  A high number of isolated lymph nodes in stage I or II colorectal carcinomas was associated with the MSI phenotype. Good prognosis that is usually associated with tumors having a high number of uninvolved lymph nodes might reflect the high prevalence of MSI among these tumors. The number of examined lymph nodes as a quality criterion should be used with caution. For stage I or stage II colorectal carcinomas, restricting MSI phenotyping to tumors with more than the mean number of lymph nodes identifies almost all MSI tumors. SN - 0004-0010 M3 - doi: 10.1001/archsurg.2009.224 UR - http://dx.doi.org/10.1001/archsurg.2009.224 ER -