Occult axillary lymph-node micrometastases in breast cancer

Gusterson, B A; Ott, R. J.; Anderson, Thomas; Galea, M.H.; Ellis,; Elston, C. W.; Blamey, R.W.

doi:10.1016/0140-6736(90)91978-j

Cited by 51 publications

(17 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Histologic examination only samples a very small portion of each lymph node, and it has been calculated that a pathologist has only a 1% chance of detecting a micrometastatic focus within a three-tumor-cell diameter (6). Thus, there is a clear need for more sensitive detection of lymph node micrometastases, thereby allowing more individualized prognosis and treatment planning for cervical cancer patients.…”

mentioning

confidence: 99%

Molecular Diagnosis of Sentinel Lymph Node Metastases in Cervical Cancer Using Squamous Cell Carcinoma Antigen

Yuan

Xiaoming

Jia³

et al. 2008

Clinical Cancer Research

View full text Add to dashboard Cite

Purpose: To clarify the prognostic value of molecular diagnosis of SLN metastases in cervical cancer using SCCA. Experimental Design: All SLNs and primary tumors, part of non-SLNs, were harvested from 36 patients with cervical cancer. Expression levels of SCCA, cytokeratin 19 (CK19), and glyceraldehyde-3-phosphate dehydrogenase (GAPDH) mRNA in 178 samples (29 primary tumors, 5 histologic positive nodes, 60 histologic negative SLNs, 69 non-SLNs, and 15 normal nodes) were assessed by quantitative reverse transcription-PCR assay. The quantitative value of SCCA or CK19 mRNA was described as each value relative to GAPDH mRNA. The cutoff value was set at the upper limit of the quantitative value of nodes from noncancer patients, and those above this value constituted the molecular metastasis group. Results: The SCCA mRNA expression values were more than 1 Â10 3 in 28 primary tumors and all histologic positive nodes, and its expression levels in SLNs were higher than in non-SLNs. SLNs from patients with adverse prognostic features had higher SCCA mRNA expression levels. Four histologic negative SLNs were diagnosed molecular metastases based on SCCA mRNA. Two cases with histologically uninvolved pelvic nodes recurred. Survival analysis indicates that molecular lymphatic metastasis based on elevated SCCA mRNA level is the best predictor of recurrence. However, CK19 is not a suitable marker due to its low specificity and relative higher baseline expression in normal nodes. Conclusions: SCCA mRNA levels for molecular diagnosis of SLN metastases in cervical cancer more accurately identifies patients at risk for recurrence than the routine histology does.

show abstract

mentioning

confidence: 99%

Molecular Diagnosis of Sentinel Lymph Node Metastases in Cervical Cancer Using Squamous Cell Carcinoma Antigen

Yuan

Xiaoming

Jia³

et al. 2008

Clinical Cancer Research

View full text Add to dashboard Cite

show abstract

“…It has been estimated that routine histopathologic examination has only a 1% chance of identifying a minute tumour cell cluster less than 3 cells' diameters. 13 Moreover, the detection of micrometastases and clusters of tumour cells is further complicated by their intranodal nonrandom distribution. 14 Clearly, exhaustive serial sectioning combined with hematoxylin-eosin staining or immunohistochemistry (IHC) for the detection of micrometastases and tumour cell clusters is time-consuming and expensive.…”

mentioning

confidence: 99%

HPV16‐E6 mRNA is superior to cytokeratin 19 mRNA as a molecular marker for the detection of disseminated tumour cells in sentinel lymph nodes of patients with cervical cancer by quantitative reverse‐transcription PCR

Häfner

Gajda

Altgassen

et al. 2007

Intl Journal of Cancer

View full text Add to dashboard Cite

About 10-15% of patients with cervical cancer suffer from recurrence despite histologically negative lymph nodes (pN0). Occult micrometastases or small tumour cell clusters may contribute to disease outcome. The aim of this study was to compare at the RNA level 2 known tumour-associated genes, HPV16-E6 and cytokeratin 19 (CK19), as molecular markers for the detection of disseminated tumour cells. Real-time reverse transcription PCR technology was used to quantify gene expression in histologically positive and negative sentinel lymph nodes (SLN) from 70 patients with cervical cancer. Lymph nodes from noncancer patients were used as controls. Calculated copy numbers were normalised to the geometric average of the most stable housekeeping genes. We observed a good correlation (R 5 0.915) between the expression of both markers in SLN with histologically confirmed metastases. However, marker gene expression differed considerably in histologically negative nodes: CK19 transcripts were detected in 90 of 112 SLN (80.4%), whereas only 38 nodes (33.9%) were positive for HPV16 E6 mRNA. In particular, 62 of 74 SLN, which were negative by histology, and HPV16 E6 mRNA expressed CK19 mRNA. Moreover, 8 of 10 lymph nodes from noncancer patients expressed CK19 mRNA. Systematic errors due to RNA degradation or incomplete cDNA could be ruled out. It is concluded that HPV16 E6 mRNA is more specific and more sensitive for the detection of tumour cells in SLN than CK19 mRNA. The specificity of CK19 is limited because of low level expression in uninvolved pelvic lymph nodes. ' 2007 Wiley-Liss, Inc.Key words: cervical cancer; disseminated tumour cells; molecular markers; HPV16-E16; cytokeratin 19; quantitative RT-PCR Cervical cancer is the second most common cancer among women world wide, accounting for 493,000 new cases in 2002. 1 The incidence rates vary considerably between different geographic regions, which reflect in part the lack of screening programs in developing countries. Despite the advancement in early diagnosis, improved surgical techniques and adjuvant therapies, approximately 40% of cervical carcinoma patients in countries with a high standard of health care die from the disease. 1 The majority of these deaths is due to metastases. 2 Different parameters such as lymph node metastases, tumour grade, lymph-vascular space involvement (LVSI) and surgical margins are prognostic factors for cervical cancer, with lymph node status as the most important one. 3,4 Patients with histologically uninvolved lymph nodes (pN0) have a better prognosis than women with histologically confirmed lymph node metastasis (pN1) showing 5 year survival rates of 88-93% and 40-63%, respectively. 5-7 Nevertheless 15% of FIGO stage IB patients with pathologically staged negative lymph nodes (pN0) suffer from recurrence. 8 The significance of micrometastases as a predictive factor for recurrent disease is the focus of several recent and ongoing studies. Extensive serial sectioning of lymph nodes that were judged to be free of disease by routine diagnos...

show abstract

“…Furthermore, it has been shown that often only one lymph node is positive [34]. This means that all lymph nodes would have to be disrupted, thereby making them unusable for any type of morphologic evaluation.…”

Section: Molecular Methodsmentioning

confidence: 98%

“…For example, Gusterson and Ott [34] have calculated that a pathologist has only a 1% chance of identifying a metastatic focus of cancer with a cross-sectional diameter of three cells within a lymph node. In addition, reexamination of lymph node sections initially considered ''negative for tumor'' after routine histologic screening frequently show metastatic tumor deposits, demonstrating that even when tumor cells are present in the section they can be missed.…”

Section: Detection Of Occult Metastases In Regional Lymph Nodes Of Pamentioning

confidence: 99%

Detection of occult metastases in lung carcinomas: Progress and implications for lung cancer staging

et al. 1998

View full text Add to dashboard Cite

Occult axillary lymph-node micrometastases in breast cancer

Cited by 51 publications

References 0 publications

Molecular Diagnosis of Sentinel Lymph Node Metastases in Cervical Cancer Using Squamous Cell Carcinoma Antigen

Molecular Diagnosis of Sentinel Lymph Node Metastases in Cervical Cancer Using Squamous Cell Carcinoma Antigen

HPV16‐E6 mRNA is superior to cytokeratin 19 mRNA as a molecular marker for the detection of disseminated tumour cells in sentinel lymph nodes of patients with cervical cancer by quantitative reverse‐transcription PCR

Detection of occult metastases in lung carcinomas: Progress and implications for lung cancer staging

Contact Info

Product

Resources

About