Prognostic Significance of Cellular Cannibalism in Colorectal Tumors

Background: Various cell-in-cell interactions are thought to be related to the aggressiveness, degree of anaplasia, invasiveness, and metastatic potential of a malignancy. One of these cellular interactions is cellular cannibalism (CC). In our study, we investigated the value of using CC as a prospective additional criterion for determining the prognosis of patients with colorectal carcinomas. We also aimed to identify potential clinical and histopathological markers, as well as molecular connections, that may be associated with CC. Methods: The hematoxylin-eosin-stained slides of the 232 patients diagnosed with colorectal adenocarcinoma were evaluated for the presence and degree of CC. The relationships between CC and demographic, and histopathological parameters, microsatellite instability status, and KRAS mutation status were evaluated statistically. Additionally, the prognostic significance of CC was investigated via multivariate analysis. Results: The relationships between high pT and pN stages and CC were statistically significant ( P  < .001). A significant association was found between lymphovascular invasion, perineural invasion, and CC ( P  < .001). Conclusions: CC was associated with poor colorectal cancer outcomes in our study. Therefore, we believe that it is important to identify and quantify cannibal cells during routine histopathology examinations to demonstrate their morphological predictive value.