ORIGINAL RESEARCH article
Front. Oncol.
Sec. Gastrointestinal Cancers: Colorectal Cancer
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1601993
This article is part of the Research TopicNational Colorectal Cancer Awareness Month 2025: Current Progress and Future Prospects on Colorectal Cancer Prevention, Diagnosis and TreatmentView all 3 articles
Risk factors and a predictive nomogram for regional lymph node metastasis in deficient mismatch repair colorectal cancer
Provisionally accepted
- 1Department of General Surgery, Second Affiliated Hospital of Xi'an Jiaotong University, Xi’an, Shaanxi Province, China
- 2Department of Pathology， Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- 3Department of Epidemiology and Biostatistics，School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, China
- 4Department of Cell Biology and Genetics，School of Basic Medical Sciences, Xi’an Jiaotong University Health Science Center, Xi’an, China
- 5Xi'an Jiaotong University, Xi'an, China
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The present study aims to investigate the risk factors associated with regional lymph node metastasis (LNM) in patients with deficient mismatch repair (dMMR) colorectal cancer and develop a nomogram for predicting it preoperatively.Clinicopathological data of patients who underwent surgical treatment at the Second Affiliated Hospital of Xi'an Jiaotong University between January 2021 to December 2024 were collected, and the logistic regression univariate and multivariate analyses were performed to identify the independent risk factors for regional LNM. A clinicopathologic nomogram for preoperatively predicting LNM was established and further validated and evaluated.A total of 131 patients with stage I to III dMMR/MSI CRC were included in the study.The results showed that age, tumor location, degree of differentiation, depth of invasion and negative IHC staining results of MMR proteins except for the doublenegative of MLH1 and PMS2 or MSH2 and MSH6 were independent risk factors of regional LNM in dMMR/MSI CRC. They were incorporated in the individualized prediction nomogram, which showed sufficient discriminability and good calibration.Decision curve analysis indicated that the nomogram could be used for early clinical prediction of regional LNM.The clinicopathological nomogram incorporating 5 independent risk factors can be widely used to facilitate the preoperative prediction of regional LNM in patients with dMMR/MSI colorectal cancer, thereby developing individual treatment and improving patients' prognosis. While the model was internally validated, further external validation is also warranted.
Keywords: colorectal cancer, Mismatch repair deficiency, lymph node metastasis, clinicopathological nomogram, risk factor
Received: 28 Mar 2025; Accepted: 26 May 2025.
Copyright: © 2025 He, Wu, Gao, Jiao, Yu, Zhao, Hou and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Ni Hou, Department of Cell Biology and Genetics，School of Basic Medical Sciences, Xi’an Jiaotong University Health Science Center, Xi’an, China
Jie Li, Xi'an Jiaotong University, Xi'an, China
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