ES02 SIGNIFICANCE OF LYMPH NODE MICROMETASTASES IN PAPILLARY THYROID CARCINOMA
4
Citation
0
Reference
10
Related Paper
Abstract:
Purpose Management of nodal disease in papillary thyroid cancer (PTC) varies. The significance of micrometastases and their relationship to locoregional recurrence has not been well described. We set out to compare patients with micrometastatic nodal disease to those with macrometastases and those with no metastases. Our service follows a policy of routine central/recurrent nerve dissection and ipsilateral jugulocarotid node sampling for cases of PTC. Methodology One hundred and seventy patients who had surgery for PTC between January 1995 and December 2000 were included and split into three groups. Micrometastases (only micrometastatic disease), Macrometastases (any macrometastaic nodal involvement) and No metastases (absence of any nodal involvement). These three groups were compared for rates of locoregional disease recurrence and distant metastases. Results Contingency analysis showed that the Macrometastases group had a significantly higher rate of locoregional recurrence compared with both No metastases(Odds ratio 7.67, p < 0.0001) and Micrometastases groups (Odds ratio 9.212, p 0.0154). There was no difference between the No metastases and micrometastases groups (p 1.000), the p value suggesting the two groups were likely to be equivalent. Analysis revealed that distant disease was significantly more common in the Macrometastases group when compared to the No metastases group, (Odds ratio 25.09, p 0.0032) Conclusions Micrometastatic nodal disease associated with PTC does not lead to higher rates of locoregional recurrence or distant disease. These patients do not need completion neck dissection and have a low risk of locoregional recurrence.Keywords:
Neck dissection
Micrometastasis
Axilla
Objective To investigate micrometastasis in axillary lymph nodes and its relationship with nm23 expression of the tumor tissue in breast cancer patients. Methods Paraffin blocks of 832 surgically removed lymph nodes and carcinoma tissues from 52 lymph node negative cases comfirmed by routine pathology were re examined by immunohistochemical staining using monoclonal anti EMA and anti nm23 H1 respectively. Results Micrometastasis were observed in 12 of the 52 patients (23.0%) and in 34 of the 832 lymph nodes ( 4.1% ). The positive rate of micrometastasis that in the tumor larger than 2.0cm or poorly differentiated was significantly higher than in the tumor 2.0cm or well differentiated (P0.01, P 0.05 ). The positive rate of nm23 expression was 51.9% (27/52) in breast cancer tissues. The positive rate of nm23 expression in the patients with micrometastasis was significantly lower than that in the patients without metastasis (P 0.05 ). Conclusions Monoclonal antibody against EMA would be used as a probe to detect lymphatic micrometastasis which not found by routine pathological method in breast cancer patients. Low nm23 expression is observed in the early stage of breast cancer with micrometastasis.
Micrometastasis
Axillary lymph nodes
Cite
Citations (0)
OBJECTIVE:To investigate the prognostic significance of gastric cancer micrometastasis in regional lymph nodes. METHODS:Thirty-one patients with pathologic T_ 1-3 N_0M_0 gastric carcinoma who underwent gastric resection between Jan. 1,1995 and Mar.31,1997 were studied. The sections of the “negative” lymph nodes diagnosed by HE staining were stained immunohistochemically by anti-CK19 monoclonal antibody. Associations between clinicopathological factors and LN micrometastasis as well as micrometastasis and survival were sought. RESULTS: Micrometastasis was found in 32.3%(10/31) of the patients. The occurrence was related with the depth of tumor invasion. The 5-year-survival of the patients with LN micrometastasis was lower than that of ones without micrometastasis. CONCLUSIONS: CK19 is a useful tumor-marker to detect micrometastasis in lymph nodes. It is also of value to predict prognosis, monitor therapeutic effects and offer suggestions for rational treatment.
Micrometastasis
Gastric carcinoma
Cite
Citations (0)
Objective To study the detection of lymph node micrometastasis in N0 colorectal cancer patients and its clinical significance in these patients.Methods In the study,453 lymph nodes obtained from 45cases of N0 colorectal cancer going curative operation were examined,using fluorescent quantity polymerase chain reaction(FQ-PCR) assay to detect cytokeratin 20(CK20) mRNA expression for identifying micrometastasis.Results Micrometastasis was detected in 46 lymph nodes(10.2%,46/453) of 20 cases(44.4%,20/45).The presence of micrometastasis was correlated with invasion depth of primary tumor,but was not related to sex,age,size and differentiation of primary tumor.The mean follow-up time in the positive groups(20 cases) with micrometastasis and the negative groups(25 cases) without micrometastasis were 19.6 and 22.4 months respectively,but there were 7 cases post-operative recurrence,metastases and 5 cases died in positive groups(20 cases) with micrometastasis,only 1 case died because of recurrence or metastases in negative groups(25 cases) without micrometastasis(χ2=7.305,P0.05).The disease-free survival of positive and negative groups was 75.0%(15/20) and 96.0%(24/25),respectively.The two groups have significant difference(χ2=4.240,P0.05).Conclusion CK20 FQ-PCR assay is a sensitive and specific method to detect lymph node micrometastasis in the patients with N0 colorectal cancer.The detection of CK20 mRNA in lymph nodes may contribute to improve the accuracy of clinical staging,determine patients' prognosis and provide information for rational adjuvant therapy.
Micrometastasis
Clinical Significance
Cite
Citations (0)
Objective To explore the feasibility of detection of micrometastasis in lymph node of Dukes'B colorectal cancer by immunohistochemistrv targeting CEA and its clinical significance. Methods CEA staining in lymph nodes from 42 cases of Dukes'B colorectal cancer was detected by immunohistochemical method to judge whether there was micrometastasis or not,and pognostic value of lymphatic micrometastasis was analyzed. Results Micrometastasis was detected in 16 lymph nodes of 10 cases from all 33O lymph nodes of 42 cases with a positive rate of 23.81% (10/42). The rate of recurrence or metastasis in the patients with lymphatic micrometastasis, 40%(4/10), was much higher than that of the patients without micrometastasis, 9.4% (3/32) (P= 0.032). Conclusions Immunohistochemistry targeting CEA was an effective method to detect micrometastasis in lymph node of colorectal cancer. Patients with lymphatic micrometastasis had a worse prognosis. Intensive postoperatice adjuvant therapy and follow-up were necessary.
Micrometastasis
Lymphovascular invasion
Adjuvant Therapy
Cite
Citations (0)
Objective To study the relationship between lymph node micrometastasis and clinicopathological parameters. Methods Immunohistochemical method was adopted to detect CK19,CK20 and CD44v6 in 509 lymph nodes from 53 cases of gastric cancer, in which, conventional pathological diagnosis showed no lymph node metastasis. Results Micrometastasis was found in 47 lymph nodes (9.2%) of 21cases ( 39.6 %). The incidence of micrometastasis was correlated with the depth of invasion, and the incidence of micrometastasis in PT 3 and PT 4 patients was more than that in PT 1 and PT 2 patients(P0.05). The incidence of micrometastasis was also higher in the poorly differentiated cancer than that in well differentiated cancer (P0.05). The histologic stage of the 19 (35.85%) micrometastasis patients was upstaged by the group of micrometastatic lymph nodes from stage Ⅰ to stage Ⅱ in 4 cases, stage Ⅲ in 15 cases. Conclusions Micrometastasis detection in negative lymph nodes of gastric cancer is recommended to precisely determine the tumor stage,in order to direct cancer therapy and predict prognosis.
Micrometastasis
Cite
Citations (0)
Background To evaluate the biological significance of the lymphnode micrometastasis in non-small-cell lung cancer (NSCLC). Methods Ninety regional lymph nodes indicated to be tumor free by conventional histopathologic methods were taken from 39 patients who underwent pulmonary resection for NSCLC. CK immunohistochemical staining was used to detect the micrometastatic tumor cells in lymph nodes. Expressions of p53, p21(ras) and Ki67 in primary pulmonary lesions were also detected by immunochemical methods. Results Micrometastasis were found in 26 lymph nodes (28.89%) of 22 patients (56.4%). The proportion of patients with micrometastasis whose primary lesions had the expressions of p53, p21(ras) and Ki67 was higher than those without micrometastasis whose primary lesions had no expressions of p53, p21(ras) and Ki67. The proportion of patients with micrometastasis whose tumor size was more than and less than 3 cm was 55.6% and 58.3% respectively (P=1.000). Conclusions Expressions of p53, p21(ras) and Ki67 in primary pulmonary lesions has certain relations with micrometastasis in lymph nodes.
Micrometastasis
Primary tumor
Cite
Citations (0)
Abstract Background and Objectives Lymph node micrometastasis is frequently detected in resected specimens of esophageal squamous cell carcinoma (ESCC). The goal of this study was to evaluate the clinical implication of micrometastasis in patients with lymph node‐negative (pN0) disease. Methods We examined the presence of micrometastasis in 2,511 lymph nodes from 53 patients with pN0 disease who underwent curative esophagectomy. All lymph nodes and the primary tumors were immunostained using an anticytokeratin antibody cocktail (AE1/AE3). Results Micrometastasis was detected in 18 lymph nodes (0.72%) from 14 patients (26.4%). Detection of micrometastasis was not associated with the depth of invasion or the differentiation or lymphatic invasion. Lymph nodes containing micrometastases were widely distributed, but the most frequently involved nodes were located along the lesser curvature of the stomach. Four patients with micrometastasis (29%) and the only two patients without micrometastasis (5%) had recurrence as lymph node metastases ( P = 0.036). There were no significant differences in recurrence‐free survival and disease‐specific survival between patients with micrometastasis and patients without micrometastasis. Conclusions These results show that micrometastasis might increase the risk of lymph node recurrence, but does not influence the survival of patients with pN0 ESCC. J. Surg. Oncol. 2002;79:224–229. © 2002 Wiley‐Liss, Inc.
Micrometastasis
Esophagectomy
Cite
Citations (46)
Objective:To inquire into the relationship of the expression of CEA-mRNA and the cell immunocompetent in patients with gastric carcinoma. Methods: 40 patients with gastric carcinoma were divided into two group by the expression of CEA-mRNA, which were the micrometastasis group and the no micrometastasis group. The clinical feature of all patients in two group, such as age, sex, invasion position, invasion stage and Brrmann category, were all investigated. The cell im-munocompetent(the rate of T, Ts, Th, NK, Th/Ts in peripheral blood) were detected too. Results: The clinical feature(such as age, sex, invasion position distribution, invasion stage and Brrmann category) between the micrometastasis group and the no micrometastasis group were similar(P0.05). The rate of T, Th, NK and the ratio of Th/Ts in peripheral blood in patients in the no micrometastasis group were higher than that in the micrometastasis group (P0.05). But the rate of Ts in peripheral blood in patients in the no micrometastasis group were lower than that in the micrometastasis group (P0.05). Conclusion: The gastric carcinoma patients with peripheral blood micrometastasis has a lower cell immunocompetent than that patients without peripheral blood micrometastasis.
Micrometastasis
Gastric carcinoma
Cite
Citations (0)
Objective To study the micrometastasis in peripheral blood,lymph node and bone marrow in patients with breast cancer and the effect of adjuvant chemotherapy on bone marrow micrometastasis.Methods RT-PCR technique was used to simultaneously detect the micrometastasis in peripheral blood,lymph node and bone marrow in 69 patients with operable breast cancer,and the effect of adjuvant chemotherapy on bone marrow micrometastasis was also investigated.Results The positivity of bone marrow micrometastasis tested by RT-PCR in breast cancer patients was 34.8%.The circulating tumor cells were found in 11 patients(15.9%).Lymph node metastasis was positive in 35 cases, out of the 35 node-positive cases,32 cases(91.4%) were lymph node micrometastasis,out of the 34 node-negative cases,eight cases(23.5%) were lymph node micrometastasis.Seven of 24 cases(29.2%) of bone marrow micrometastasis positive patients became negative after receiving six cycles of CAF adjuvant chemotherapy.Conclusions Detection of CK19mRNA by RT-PCR is a sensitive and specific method of assessing micrometastasis in patients with breast cancer.Compared with the detection of bone marrow micrometastasis,the technique to detect the micrometastasis in peripheral blood is less sensitive or specific.The detection of bone marrow micrometastasis is a sensitive index to assess the effect of adjuvant chemotherapy.
Micrometastasis
Cite
Citations (0)
Objective To study the relationship between lymphnode micrometastasis and clinicopathological parameters.Methods Immunohistochemical method was adopted to detect CK20 and CEA in 509 lymphnodes from 53 cases of colorectal cancer,in which,conventional pathological diagnosis showed no lymph node metastasis.Results Micrometastasis was found in 47 lymphnodes (9.2%) of 21 cases (39.6%).The incidence of micrometastasis was correlated with the depth of invasion,and the incidence of micrometastasis in PT3 and PT4 patients was more than that in PT1 and PT2 patients(P0.05).The incidence of micrometastasis was also higher in the poorly differentiated cancer than that in well differentiated cancer (P0.05).The histologicstage of the 19 (35.85%) micrometastasis patients was upstaged by the group of micrometastatic lymph nodes from stage Ⅰ tostage Ⅱin 4 cases,stage Ⅲ in 15 cases.Conclusion Micrometastasis detection in negative lymph nodes of colorectal cancer is recommended to precisely determine the tumor stage,in order to direct cancer therapy and predict prognosis.
Micrometastasis
Cite
Citations (0)