Current status of lymph node micrometastasis in gastric cancer

Zhou, Yang; Zhang, Guojing; Wang, Ji; Zheng, Kaiyuan; Fu, Weihua

doi:10.18632/oncotarget.17495

Cited by 32 publications

(22 citation statements)

References 39 publications

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“… 28 , 29 Furthermore, lymph node metastasis is also recognised as a critical risk factor for recurrence in GC patients receiving curative surgery. 30 Therefore, elucidation of pivotal factors involved in the metastatic process might be used as new prognostic markers for early detection of recurrence and improvement of prognosis in GC patients. L1CAM is one of the transmembrane adhesion molecules, and several lines of evidence show that L1CAM overexpression is significantly correlated with metastasis-related clinicopathological factors and unfavourable outcome in various malignancies.…”

Section: Discussionmentioning

confidence: 99%

Clinical significance and biological role of L1 cell adhesion molecule in gastric cancer

et al. 2019

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Background L1 cell adhesion molecule (L1CAM) is highly expressed in malignant tumours and might play a pivotal role in tumour progression. Methods We analysed by immunohistochemistry L1CAM protein expression in formalin-fixed, paraffin-embedded specimens from 309 GC patients. We performed propensity score matching (PSM) analysis to clarify the prognostic impact of L1CAM in GC patients. We evaluated L1CAM gene expression in fresh frozen specimens from another group of 131 GC patients to establish its clinical relevance. The effects of changes in L1CAM were investigated in vitro and in vivo. Results L1CAM was mainly expressed in tumour cells of GC tissues. Elevated L1CAM expression was an independent prognostic factor for overall and disease-free survival, and an independent risk factor for distant metastasis in GC patients. PSM analysis showed that high L1CAM expression was significantly associated with poor prognosis. L1CAM gene expression using fresh frozen specimens successfully validated all of these findings in an independent cohort. Inhibition of L1CAM suppressed cell proliferation, cycle progress, invasion, migration and anoikis resistance in GC cells. Furthermore, L1CAM inhibition suppressed the growth of peritoneal metastasis. Conclusion L1CAM may serve as a feasible biomarker for identification of patients who have a high risk of recurrence of GC.

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Section: Discussionmentioning

confidence: 99%

Clinical significance and biological role of L1 cell adhesion molecule in gastric cancer

et al. 2019

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“…The principal revision of the new edition was incorporation of pN3b as a separate group in the staging system. Lymph node metastasis was considered as an important prognostic factor for gastric cancer [23][24][25][26]. Although the optimal number of lymph nodes required for examination remains controversial, it is traditionally recommended that at least 16 lymph nodes should be examined during Fig.…”

Section: Discussionmentioning

confidence: 99%

Validation of the American Joint Committee on Cancer (AJCC) 8th edition stage system for gastric cancer patients: a population-based analysis

Lin

et al. 2017

Gastric Cancer

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“…This can impair the implementation of LN micrometastases search at pathology laboratories due to the work overload caused by this procedure [15][16][17][18] . In either way, when searching for LN micrometastases, it is recommended IHC using anti-cytokeratin antibodies as it increases the micrometastases detection rate 19,20 .…”

Section: Discussionmentioning

confidence: 99%

Impact of multisection and immunohistochemistry in lymph node staging of Gastric Carcinoma – Case series

Santos

Drummond-Lage

Wainstein

et al. 2020

Sci Rep

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Gastric carcinoma (GC) locoregional recurrence may occur even in cases where the tumor has been completely resected, possibly due to lymph node (LN) micrometastases. It is estimated that in 10% to 30% of cases, LN micrometastases are not detected by a conventional method for histological assessment of LN metastases with hematoxylin-eosin (HE). A cross-sectional study assessed 51 patients with GC by histological evaluation of the LN micrometastases through LN multi sectioning associated with immunohistochemistry analysis with monoclonal antibodies AE1 and AE3. Total gastrectomy was performed in 51% of patients. The total number of resected LN nodes was 1698, with a mean number of resected LN of 33.3 ± 13.2 per surgical specimen, of which 187 had metastasis. After the application of LN multisection and immunohistochemistry, LN micrometastases were found in 45.1% of the cases. LN staging changed in 29.4%, and tumor staging changed in 23.5% of the cases. In patients initially staged as pN0, LN staging and tumor staging changed, both in 19.2% of the cases. In patients initially staged as pN1 or more, LN staging changed in 40.0% of them, and tumor staging changed in 28.0% of the cases. The accuracy of HE for the histological staging of LN tumoral involvement was 76%, which was considered insufficient for CG patients staging. Investigation of LN micrometastasis through LN multisection and immunohistochemistry should be performed, particularly in cases where the presence of blood and lymphatic vessel invasion has been identified after conventional histological analysis, as well as in patients with advanced Gc. Gastric carcinoma (GC), despite the recent decrease observed in its incidence, remains the second most common cause of cancer death in the world, with more than 600,000 deaths per year. The main chance of cure of this neoplasm is on surgical resection. The standard procedure for the treatment of this condition is radical gastrectomy, which includes gastric resection with surgical margins free of neoplasia, associated with extended locoregional lymphadenectomy 1-3. Accurate tumor staging is one of the leading factors in the definition of the therapeutic strategy. From the exact knowledge of the extent of tumor dissemination, it is possible to define, with greater security, the best therapeutic approach for each patient, and, consequently, avoid incomplete or excessive treatments 4,5. Recent literature has discussed the role of lymph node (LN) micrometastasis in GC. Conceptually, micrometastases are metastases of sizes between 0.2 mm and 2.0 mm (5). Its incidence varies between 10% to 30% 6,7. Currently, many authors admit that its presence is associated with a worse prognosis and that the clinical behavior of these patients is like those with lymph node involvement by metastasis 8. In the submucosal GC (T1b), with the absence of LN metastases and micrometastases, the five-year survival rate is close to 100%, being significantly higher than in micrometastases positive cases (82%) 6. The presence of micrometastasis ma...

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Current status of lymph node micrometastasis in gastric cancer

Cited by 32 publications

References 39 publications

Clinical significance and biological role of L1 cell adhesion molecule in gastric cancer

Clinical significance and biological role of L1 cell adhesion molecule in gastric cancer

Validation of the American Joint Committee on Cancer (AJCC) 8th edition stage system for gastric cancer patients: a population-based analysis

Impact of multisection and immunohistochemistry in lymph node staging of Gastric Carcinoma – Case series

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