Micrometastasis and tumor cell microinvolvement of lymph nodes from esophageal squamous cell carcinoma

Abstract

BACKGROUND The purpose of this study was to investigate micrometastasis (MM) and tumor cell microinvolvement (TCM) in the regional lymph nodes of patients with esophageal squamous cell carcinoma (SCC). METHODS MM was defined as individual tumor cells or tumor cell clusters <0.5 mm in greatest dimension with a surrounding stromal reaction. TCM was defined as individual tumor cells or tumor cell clusters without a surrounding stromal reaction. One thousand nine hundred and fifty‐four lymph nodes were dissected from 69 complete (R0) resection specimens of TNM classified pT1‐3, pN0 or pN1, and M0 esophageal SCC. These lymph nodes were examined immunohistochemically using the monoclonal antibody cocktail AE1/AE3 for cytokeratins. The primary tumors were immunostained with an anti‐E‐cadherin monoclonal antibody. RESULTS MM ± TCM was found in 13 cases (31.7%) and TCM alone in 2 cases (4.9%) of the 41 pN0 cases. The pN0 patients with MM (but not TCM) had the same shorter survival as the original pN1 cases (P < 0.05). Of the 69 primary tumors, 49 (71.0%) had reduced or negative E‐cadherin expression that showed a correlation with the occurrence of lymph node metastases (original pN1), MM, and TCM, but not prognosis. CONCLUSIONS The results of the current study show that, in SCC of the esophagus, MM, but not TCM, in the regional lymph nodes is prognostically equivalent to metastasis and should be examined by immunohistochemistry to classify these cases correctly as pN1. Cancer 1998;83:858‐866. © 1998 American Cancer Society.

Novel Biomedical Imaging Approach for Detection of Sentinel Nodes in an Orthotopic Xenograft Rat Model of Human Gastric Carcinoma

“…rates by RT-PCR assay than conventional histopathological examination (Bilchik et al, 2001;Kitagawa & Kitajima, 2002;Maruyama et al, 1999;Natsugoe, et al, 1998;Noura et al, 2002), these results showed high sensitivity and specificity of the ATX-S10Na (II)-guided method for the detection of SNs. Because micrometastasis occurs frequently in gastric carcinoma, the system using ATXS10Na (II) may be a novel technology to detect micrometastases with high sensitivity, resulting in reduction of false-negative LNs.…”

Significance of immunohistochemical nodal micrometastasis as a prognostic indicator in potentially curable oesophageal carcinoma

“…Glickman et al 21 did not ®nd a correlation between the presence of occult lymph node metastasis and poor survival for patients with oesophageal cancer. In contrast, Izbicki et al 8 and Natsugoe et al 9 have found nodal micrometastases to be a signi®cant indicator of a poorer prognosis after oesophagectomy. The authors' previous study was consistent with the ®ndings of the latter authors 7 .…”

“…Natsugoe et al 9 have demonstrated that patients without overt nodal metastasis but with newly identi®ed micrometastases have the same poor prognosis as patients with overt metastasis. The same in¯uence of nodal micrometastasis on postoperative survival was observed in the present study; the survival curve of patients without overt metastasis but with micrometastases was similar to that of patients with one to four overt metastatic nodes not accompanied by micrometastasis.…”

Rapid immunohistochemical detection of tumor cells in gastric carcinoma

“…Similarly, in patients with advanced cancer, distant lymph nodes should be removed if LNM is found in regional lymph nodes. In patients with carcinoma of the oesophagus and stomach, the reported prognosis was worse in those with LNM (35,(41)(42)(43)(44).…”