Routine elastic staining assists detection of vascular invasion in colorectal cancer

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Abstract
To determine the value of routine staining of colorectal cancer (CRC) specimens with elastic stains. Four hundred and ninety-eight cases of CRC were included. In 208 cases, vascular invasion (VI) was assessed using elastic stains [Elastic van Gieson or Elastin haematoxylin and eosin (H&E)] that were introduced as routine staining in CRC in our hospital. As a control, 290 cases in which VI was assessed solely on H&E staining were included. The site, stage and presence of vascular invasion were determined in both groups. The cost, time and workload resulting from the addition of these stains were also taken into account. The sensitivity of detection of VI in CRC was significantly improved after the introduction of these elastic stains in our routine practice (46.2% compared with 35.5% in the control group; P = 0.014). Particular improvement was noted in Dukes' stage A and B. We also noted that the net benefits gained from the introduction of these special stains outweighed the small extra cost and effort and, in addition, saved time for the reporting pathologists. Routine elastic stains are very useful and practical in evaluation of VI status in CRC and we recommend implementing these stains in routine pathological practice to improve patient care.