Micrometastases detected by cytokeratin 19 expression in sentinel lymph nodes of patients with early-stage cervical cancer

Wang, H. Y.; Sun, Jie; Li, Hong; Shi, Daren; Ou, Z. L.; Ren, Yu; Fu, Siqing

doi:10.1111/j.1525-1438.2006.00381.x

Cited by 46 publications

(35 citation statements)

References 26 publications

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“…CK19 is the most common diagnostic marker of LN micro-metastasis in gynecological malignant tumors (7,34,35). Our study revealed that, in the primary lesion and metastatic LNs, the positive expression rate of HPA was over 80% and no less than the rate of CK19, which supported the theory that HPA could be a promising biomarker of LN metastasis in cervical cancer.…”

Section: Discussionsupporting

confidence: 82%

Significance of heparanase in metastatic lymph nodes of cervical squamous cell cancer

Wang

Shi

et al. 2017

Oncology Letters

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Abstract. The aim of this study was to explore the expression of heparanase (HPA) in metastatic lymph nodes (LNs) of cervical cancer and to evaluate HPA as a marker of micro-metastasis of LNs. Immunohistochemistry was performed to detect the expression of HPA in 53 cases with metastasis of LNs (group A) and 49 cases without (group B). Scoring was determined based on the intensity of immuno staining and the size of the staining area. Three points or higher score was considered as positive. Among all cases, the positive rate of HPA was 76.5% in primary lesions and 84.9% in both primary lesions and metastatic LNs in group A. In group B, the rates were 67.3% in primary lesions and 8.2% in metastatic LNs. The expression of HPA in group A was significantly higher than that in group B (P<0.05). Compared with stage IA-IB and well-differentiated and non-metastatic LNs, the LNs of stage IIA and moderately/poorly differentiated and metastatic LNs expressed higher HPA (P<0.05). The overall 5-year survival rate was 73.3% and the median overall survival time (MOS) was 49.0 months. The MOS of the two groups was 36.0 and 58.5 months, respectively (P=0.023); the MOS of patients with positive HPA expression was distinctly lower than that of negative patients (P=0.040). Clinical staging, degree of differentiation, lymph node metastasis and expression of HPA notably affected patient prognosis; lymph node metastasis and expression of HPA were independent risk factors affecting patient prognosis (P<0.05). Our study demonstrated that high-level expression of HPA in cervical cancer was involved in LN metastasis, further impacting on patients' long-term survival. The clinical value of HPA requires further in-depth study.

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Section: Discussionsupporting

confidence: 82%

Significance of heparanase in metastatic lymph nodes of cervical squamous cell cancer

Wang

Shi

et al. 2017

Oncology Letters

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“…The OSNA assay showed 96.2% agreement with 2-mm slice histopathological examination. Wang et al [34] detected micrometastasis using RT-PCR and immunohistochemistry for cytokeratin 19 expression in 46 cervical cancer patients. Both RT-PCR and immunohistochemistry are more sensitive in identifying micrometastasis than conventional pathological examination.…”

Section: Discussionmentioning

confidence: 99%

Value of Intraoperative Cytological and Pathological Sentinel Lymph Node Diagnosis in Fertility-Sparing Trachelectomy for Early-Stage Cervical Cancer

et al. 2017

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Background and Objectives: Trachelectomy, a fertility-sparing surgery for early-stage cervical cancer, can be performed only when there is no extrauterine extension present. Therefore, identifying the sentinel lymph nodes (SLNs) and using them to obtain an intraoperative pathologic diagnosis can provide information on the feasibility and safety of trachelectomy. Our aim was to assess the value of an intraoperative SLN diagnosis. Methods: We retrospectively analyzed the accuracy of intraoperative imprint cytology and frozen-section examination in 201 patients at our institution in whom trachelectomy was planned. Results: All patients could be evaluated for SLNs; a total of 610 SLNs were analyzed. Although the specificity of both imprint cytology and frozen-section examination was 100.0%, the sensitivity was only 58.6 and 65.5%, respectively. The diagnostic sensitivity was higher in 2-mm slices along the short axis than on bisection along the longitudinal axis. Imprint cytology correctly diagnosed 2 patients who had false-negative results on frozen section. The nature of the metastatic foci that caused an intraoperative false-negative diagnosis was either micrometastasis or isolated tumor cells. Conclusions: The accuracy of intraoperative SLN diagnosis requires improvement, especially when small metastatic foci are present.

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“…Thus, CK is still the most commonly applied as monitoring index in studies on micrometastases of cervical cancer. A recent study, in which CK19 was used as an index for detecting micrometastases in sentinal lymph nodes of cervical cancer, by Wang et al (10) found that the detection rates of micrometastases were 42.85 and 20% using PCR and IHC, respectively, and suggested that PCR was more sensitive than IHC. Moreover, Van Trappen et al (4) also noted that 44% of pathologically-negative lymph nodes expressed CK19, and that early micrometastases occured in 50% of patients with cervical cancer.…”

Section: Discussionmentioning

confidence: 99%

Expression of high-risk HPV DNA and CK19 in pelvic lymph nodes in stage Ⅰa-Ⅱa cervical cancer and their clinical value

et al. 2012

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Abstract. The aim of this study was to investigate the detection rate and methods of micrometastases in early-stage cervical cancer by detecting the expression of high-risk HPV DNA and CK19 in pelvic lymph nodes. A total of 104 lymph nodes with/without pathologically confirmed metastases, from 28 patients with early-stage cervical cancer, were included for detection of high-risk HPV DNA and CK19 expression using in situ hybridization and immunohistochemistry, respectively. The detection rate of high-risk HPV DNA and CK19 in lymph nodes in patients with pathologically-confirmed lymph node metastases was higher compared to that in lymph nodes in patients without pathologically-confirmed lymph node metastases (P<0.001). In all 80 pathologically-negative lymph nodes, the positivity rates of high-risk HPV DNA and CK19 detection were 45 and 25%, respectively. In 57 lymph nodes in patients without pathologically-confirmed lymph node metastases the positivity rates of high-risk HPV DNA and CK19 detection were 43.5 and 24.6%. The detection rate of high-risk HPV DNA and CDK19 in 15 patients without pathologically-confirmed lymph node metastases were 60 and 46.6%, respectively. The detection rates of high-risk HPV DNA and CK19 in 104 lymph nodes were 56.7 and 41.3% (KI=0.46). The results of the two detection methods showed good consistency. Both detection of high-risk HPV DNA by in situ hybridization, and CK19 by immunohistochemical method detected lymph node micrometastases in early-stage cervical cancer. As a method of detection on the molecular level, in situ hybridization was more sensitive for the detection of lymph node micrometastases in early-stage cervical cancer.

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Micrometastases detected by cytokeratin 19 expression in sentinel lymph nodes of patients with early-stage cervical cancer

Cited by 46 publications

References 26 publications

Significance of heparanase in metastatic lymph nodes of cervical squamous cell cancer

Significance of heparanase in metastatic lymph nodes of cervical squamous cell cancer

Value of Intraoperative Cytological and Pathological Sentinel Lymph Node Diagnosis in Fertility-Sparing Trachelectomy for Early-Stage Cervical Cancer

Expression of high-risk HPV DNA and CK19 in pelvic lymph nodes in stage Ⅰa-Ⅱa cervical cancer and their clinical value

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