Accuracy of Elastic Tissue Stain in Detecting Venous Invasion in Colorectal Cancer

Objective: To determine the accuracy of Elastic tissue stains in detecting venous invasion in Colorectal cancer (CRC). Methods: Hematoxylin and Eosin (H&E) stained section from 100 cases of colorectal carcinoma were assessed for presence of venous invasion and compared with sections stained with Elastic Van Gieson (EVG) stain. Total number of cases showing evidence of venous invasion with H&E and EVG were calculated. Results: In total of 100 patients, 52 (52%) were males and 48 (48%) were females. The mean age of patients in the study sample was 59.80±19 SD years. A total of 32 cases initially assessed on H&E stained sections showed evidence of VI while the remaining 68 cases were negative for VI. When EVG stained sections were assessed, VI was seen in 59 (59%) cases while 41 cases did not show any evidence of VI on EVG. Among these 59 cases, 32 cases which were initially positive on H&E were also positive on EVG (True positive). The remaining 27 cases did not show any evidence of VI on H&E but showed VI on EVG stained sections (false negative). A total of 41(41%) cases did not show venous invasion with any of the two stains (True negative). The overall diagnostic accuracy of EVG in detection of venous invasion (VI) in CRC was 59 % whereas the sensitivity, specificity, positive predictive value, and negative predictive value were 54.24%, 100%, 100%, and 60.29%. Conclusion: Venous invasion was seen in more cases with EVG as compared to H&E alone. This stain is cheap and less time consuming, so it should be incorporated into routine reporting of colorectal carcinoma.