Immunohistochemical evaluation of lymph node micrometastases from gastric carcinomas

Ishida, Kumiko; Katsuyama, Tsutomu; Sugiyama, Atsushi; Kawasaki, Seiji

doi:10.1002/(sici)1097-0142(19970315)79:6<1069::aid-cncr3>3.0.co;2-b

Cited by 153 publications

(109 citation statements)

References 16 publications

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“…In the present study, only a single cancer cell or scattered cancer cells in the lymph nodes were detected in 65% of the 43 patients with CK-positive lymph nodes. It is still unclear whether these single or scattered cancer cells remain alive in the lymph node, or if they are destroyed or removed by the immune response of the host [12]. It was interesting to note, however, that 73% of these patients with only single or scattered cancer cells in the lymph node showed a marked loss of expression of Ecad in their primary tumor.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, micrometastasis in the lymph node has been detected by cytokeratin (CK) immunostaining [12][13][14]. The clinicopathological significance of these so-called micrometastases in the lymph nodes and the correlation of these micrometastases with the reduced expression of E-cadherin (E-cad), which has been recognized as an important factor in tumor metastasis [15], have not been extensively discussed.…”

Section: Introductionmentioning

confidence: 99%

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Significant correlation between micrometastasis in the lymph nodes and reduced expression of E-cadherin in early gastric cancer

et al. 2001

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Significant correlation between micrometastasis in the lymph nodes and reduced expression of E-cadherin in early gastric cancer

et al. 2001

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“…Serial sectioning (Isozaki et al, 1997), immunohistochemical staining (Ishida et al, 1997) and more recently reverse transciptase-polymerase chain reaction (RT-PCR) (Mori et al, 1995) will increase the detection of occult metastases.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the 5th edition of the TNM classification for gastric cancer: improved prognostic value

et al. 2001

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SummaryThe main change in the 5th edition (1997) of the TNM classification for gastric cancer compared to the 4th edition (1987) is the use of the number of involved nodes instead of the location of positive nodes. As a result stage grouping is also altered. A second change is the requirement for the examination of at least 15 nodes to justify the N0 status. Patients with fewer examined negative nodes are unclassifiable (Nx). Data were retrieved from a randomized trial database comparing D1 and D2 dissection and 633 curatively operated patients were included. According to the criteria of the 5th edition, 39% of the node-positive patients had another N stage compared to the 4th: 21% had a lower and 18% had a higher stage. 5-year survival rates according to the 4th edition N0, N1 and N2 groups were respectively 72%, 34% and 27%. According to the 5th edition these percentages were for the N0, N1, N2, N3 and Nx groups respectively 75%, 38%, 19%, 8% and 65%. The former 1987 N1 and N2 group were significantly split into three new N 1997 groups (P = 0.006, respectively P < 0.0005). The Cox's regression analysis showed the N 1997 classification to be the most important prognostic variable, with a higher prognostic value than N 1987. In addition, the new TNM stage was also a better prognosticator. The requirement for examining at least 15 nodes, however, could not be fulfilled in 38% of all nodenegative patients and we found that a minimum of 5 consecutive negative lymph nodes is a reliable number for staging purposes. We conclude that the 5th edition of the TNM classification provides a better estimation of prognosis, however, examination of at least 15 negative regional lymph nodes is too high a threshold and 5 gives similar prognostic value. 64-71 © 2001 Cancer Research Campaign doi: 10.1054/ bjoc.2000.1548, available online at http://www.idealibrary.com on http://www.bjcancer.com abdominal washing, 35 due to resection-line involvement and 3 patients due to positive cytology as well as positive margins. In 5 of the remaining 639 R0 patients, no primary tumour could be found and in one patient the T-stage could not be determined due to inadequate specimen handling. The present report will therefore be based on 633 patients, including 44 patients who died in the post-operative phase (in-hospital death or within 30 days after surgery), since the postoperative mortality was different between the D1 and D2 group (15 versus 29 patients). Survival time was calculated from the date of surgery until death or last follow-up alive. The range in follow-up time of patients still alive was 6.0 to 10.2 years, with a median follow-up of 7.9 years. ClassificationsIn (Table 2). As said before, we had to make additional to the official 1997 TNM definitions, a Nx category and consequently an 'unclassifiable' TNM category for the node-negative patients with <15 lymph nodes examined (TNMx). StatisticsThe χ 2 test was applied to assess differences in the distribution of patients among groups. The Mann-Whitney test was used for comparis...

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“…However, a disadvantage of this approach is that imaging cannot accurately diagnose lymph node micrometastasis. The clinical significance of lymph node micrometastasis in gastric cancers remains controversial (Ishida et al, 1997). Therefore, lymphatic invasion in resected specimens should be examined not only by staining with HE but also with D2-40 to predict lymph node micrometastasis.…”

Section: Lymphatic Invasion and Micrometastasis In Gastric Cancer T Amentioning

confidence: 99%

“…Therefore, radical lymphadenectomy for gastric cancer has become a standard procedure, resulting in the long-term survival of patients with lymph node metastasis (Maehara et al, 1992). Nevertheless, several authors have reported that complete resection with radical lymphadenectomy that led to a nodenegative (pN0) final diagnosis according to routine histological haematoxylin -eosin (HE) staining did not prevent recurrence (Maehara et al, 1996;Siewert et al, 1996;Ishida et al, 1997). The key causative factor of recurrent gastric cancer is lymph node micrometastasis.…”

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confidence: 99%

Lymphatic invasion using D2-40 monoclonal antibody and its relationship to lymph node micrometastasis in pN0 gastric cancer

et al. 2005

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The monoclonal antibody D2-40 is a specific lymphatic endothelial markers and D2-40 staining have been applicable to evaluate lymphatic invasion in various malignant neoplasms. In the present study, we investigated lymph node micrometastasis determined by immunohistochemistry (IHC) and reverse transcription -polymerase chain reaction (RT -PCR) in all dissected lymph nodes obtained from 80 patients with node-negative gastric cancer, and analysed the relationship between micrometastasis and clinicopathological findings including lymphatic invasion of the resected primary tumour using D2-40 immunohistochemical staining. The incidence of micrometastasis determined by IHC and RT -PCR was 11.3% (nine out of 80) and 31.3% (25 out of 80), respectively. Although haematoxylin -eosin (HE) staining revealed lymphatic invasion in 11.3% (nine out of 80) of patients, D2-40 staining uncovered new invasion in 23.8% (19 out of 80) of patients. In the diagnosis of HE and D2-40 staining, the incidence of micrometastasis was significantly higher in patients with lymphatic invasion than in those without lymphatic invasion (P ¼ 0.0150 and Po0.0001, respectively). Micrometastasis correlated more closely with D2-40 than with HE staining. We demonstrated a high incidence of micrometastasis and lymphatic invasion and a correlation between them even in pN0 gastric cancer. When planning less invasive treatment, the presence of such occult cancer cells should be considered.

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Immunohistochemical evaluation of lymph node micrometastases from gastric carcinomas

Abstract: The findings of this study indicate that the presence of micrometastases in lymph nodes is an indispensable factor in determining the prognosis of gastric carcinoma patients.

Cited by 153 publications

References 16 publications

Significant correlation between micrometastasis in the lymph nodes and reduced expression of E-cadherin in early gastric cancer

Significant correlation between micrometastasis in the lymph nodes and reduced expression of E-cadherin in early gastric cancer

Evaluation of the 5th edition of the TNM classification for gastric cancer: improved prognostic value

Lymphatic invasion using D2-40 monoclonal antibody and its relationship to lymph node micrometastasis in pN0 gastric cancer

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