Cytokeratin Is a Superior Marker for Detection of Micrometastatic Biliary Tract Carcinoma

Histological features of lymph node metastasis in patients with biliary tract cancer

“…For biliary cancers, reports from some investigators suggest that immunohistochemical detection is prognostically significant [26][27][28], while others suggest that it is not [29,30]. Intraoperative diagnosis of LN micrometastasis, either by rapid immunostaining or real-time rapid reverse transcriptase-polymerase chain reaction (which serve to guide surgeons to areas of appropriate LN dissection), has also been reported [31,32].…”

Adenocarcinoma of the Gallbladder (Classical Gallbladder Cancer)

“…The detection rate depends in the size and geometry of micrometastases. Tiny aggregates of cancer cells can be detected by means of cytokeratin immunohistochemistry in histologically negative lymph nodes (Yokoyama et al 1999;Natarajan et al 2005;Sasaki et al 2006). In one study, 7 out of 255 HE-negative lymph nodes (2.7 %) were found to be positive for micrometastases by the use of cytokeratin immunostaining (Tajima et al 1999).…”

Prognostic implications of lymph node involvement in bladder cancer: are we understaging using current methods?

“…Immunohistochemical (IHC) staining, which can detect one tumour cell among 10 000–100 000 normal cells, more clearly delineates target tumour cells from surrounding lymphoid follicular cells than does H&E staining, thus facilitating the pathologist’s task of detecting tumour cells [47]. These techniques have been used to detect nodal disease in breast, cervical and prostate cancers, showing sensitivities greater than or equal to standard pathological evaluation [48–53]. A modification of reverse transcriptase‐PCR (RT‐PCR), real‐time quantitative PCR (qPCR), has replaced PCR to serve as the basic technique used by several investigators for detecting nodal disease [54,55].…”

“…Cytokeratin is a non‐specific epithelial cell marker. Both IHC analysis and RT‐PCR for cytokeratin have been used to identify micrometastases in lymph nodes initially read as pathologically negative in other cancers [53,58]. In addition IHC staining for cytokeratin is routinely performed for identification of large volume metastasis, or to confirm the primary origin of a tumour as urothelial.…”