DETECTION OF OCCULT LYMPH NODE TUMOR CELLS IN NODE-NEGATIVE GASTRIC CANCER PATIENTS
ABSTRACT Background: The presence of lymph nodes metastasis is one of the most important prognostic indicators in gastric cancer. The micrometastases have been studied as prognostic factor in gastric cancer, which are related to decrease overall survival and increased risk of recurrence. However,...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Colégio Brasileiro de Cirurgia Digestiva
2017-03-01
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| Series: | ABCD: Arquivos Brasileiros de Cirurgia Digestiva |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202017000100030&tlng=en |
| _version_ | 1818731075270082560 |
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| author | Marina Alessandra PEREIRA Marcus Fernando Kodama Pertille RAMOS Andre Roncon DIAS Osmar Kenji YAGI Sheila Friedrich FARAJ Bruno ZILBERSTEIN Ivan CECCONELLO Evandro Sobroza de MELLO Ulysses RIBEIRO-JR |
| author_facet | Marina Alessandra PEREIRA Marcus Fernando Kodama Pertille RAMOS Andre Roncon DIAS Osmar Kenji YAGI Sheila Friedrich FARAJ Bruno ZILBERSTEIN Ivan CECCONELLO Evandro Sobroza de MELLO Ulysses RIBEIRO-JR |
| author_sort | Marina Alessandra PEREIRA |
| collection | DOAJ |
| description | ABSTRACT Background: The presence of lymph nodes metastasis is one of the most important prognostic indicators in gastric cancer. The micrometastases have been studied as prognostic factor in gastric cancer, which are related to decrease overall survival and increased risk of recurrence. However, their identification is limited by conventional methodology, since they can be overlooked after routine staining. Aim: To investigate the presence of occult tumor cells using cytokeratin (CK) AE1/AE3 immunostaining in gastric cancer patients histologically lymph node negative (pN0) by H&E. Methods: Forty patients (T1-T4N0) submitted to a potentially curative gastrectomy with D2 lymphadenectomy were evaluated. The results for metastases, micrometastases and isolated tumor cells were also associated to clinicopathological characteristics and their impact on stage grouping. Tumor deposits within lymph nodes were defined according to the tumor-node-metastases guidelines (7th TNM). Results: A total of 1439 lymph nodes were obtained (~36 per patient). Tumor cells were detected by immunohistochemistry in 24 lymph nodes from 12 patients (30%). Neoplasic cells were detected as a single or cluster tumor cells. Tumor (p=0.002), venous (p=0.016), lymphatic (p=0.006) and perineural invasions (p=0.04), as well as peritumoral lymphocytic response (p=0.012) were correlated to CK-positive immunostaining tumor cells in originally negative lymph nodes by H&E. The histologic stage of two patients was upstaged from stage IB to stage IIA. Four of the 28 CK-negative patients (14.3%) and three among 12 CK-positive patients (25%) had disease recurrence (p=0.65). Conclusion: The CK-immunostaining is an effective method for detecting occult tumor cells in lymph nodes and may be recommended to precisely determine tumor stage. It may be useful as supplement to H&E routine to provide better pathological staging. |
| first_indexed | 2024-12-17T23:11:54Z |
| format | Article |
| id | doaj.art-ee7147249b1b408697b75c40c442a271 |
| institution | Directory Open Access Journal |
| issn | 0102-6720 |
| language | English |
| last_indexed | 2024-12-17T23:11:54Z |
| publishDate | 2017-03-01 |
| publisher | Colégio Brasileiro de Cirurgia Digestiva |
| record_format | Article |
| series | ABCD: Arquivos Brasileiros de Cirurgia Digestiva |
| spelling | doaj.art-ee7147249b1b408697b75c40c442a2712022-12-21T21:29:06ZengColégio Brasileiro de Cirurgia DigestivaABCD: Arquivos Brasileiros de Cirurgia Digestiva0102-67202017-03-01301303410.1590/0102-6720201700010009DETECTION OF OCCULT LYMPH NODE TUMOR CELLS IN NODE-NEGATIVE GASTRIC CANCER PATIENTSMarina Alessandra PEREIRAMarcus Fernando Kodama Pertille RAMOSAndre Roncon DIASOsmar Kenji YAGISheila Friedrich FARAJBruno ZILBERSTEINIvan CECCONELLOEvandro Sobroza de MELLOUlysses RIBEIRO-JRABSTRACT Background: The presence of lymph nodes metastasis is one of the most important prognostic indicators in gastric cancer. The micrometastases have been studied as prognostic factor in gastric cancer, which are related to decrease overall survival and increased risk of recurrence. However, their identification is limited by conventional methodology, since they can be overlooked after routine staining. Aim: To investigate the presence of occult tumor cells using cytokeratin (CK) AE1/AE3 immunostaining in gastric cancer patients histologically lymph node negative (pN0) by H&E. Methods: Forty patients (T1-T4N0) submitted to a potentially curative gastrectomy with D2 lymphadenectomy were evaluated. The results for metastases, micrometastases and isolated tumor cells were also associated to clinicopathological characteristics and their impact on stage grouping. Tumor deposits within lymph nodes were defined according to the tumor-node-metastases guidelines (7th TNM). Results: A total of 1439 lymph nodes were obtained (~36 per patient). Tumor cells were detected by immunohistochemistry in 24 lymph nodes from 12 patients (30%). Neoplasic cells were detected as a single or cluster tumor cells. Tumor (p=0.002), venous (p=0.016), lymphatic (p=0.006) and perineural invasions (p=0.04), as well as peritumoral lymphocytic response (p=0.012) were correlated to CK-positive immunostaining tumor cells in originally negative lymph nodes by H&E. The histologic stage of two patients was upstaged from stage IB to stage IIA. Four of the 28 CK-negative patients (14.3%) and three among 12 CK-positive patients (25%) had disease recurrence (p=0.65). Conclusion: The CK-immunostaining is an effective method for detecting occult tumor cells in lymph nodes and may be recommended to precisely determine tumor stage. It may be useful as supplement to H&E routine to provide better pathological staging.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202017000100030&tlng=enGastric cancerMicrometastasisLymph node metastasisImmunohistochemistry. |
| spellingShingle | Marina Alessandra PEREIRA Marcus Fernando Kodama Pertille RAMOS Andre Roncon DIAS Osmar Kenji YAGI Sheila Friedrich FARAJ Bruno ZILBERSTEIN Ivan CECCONELLO Evandro Sobroza de MELLO Ulysses RIBEIRO-JR DETECTION OF OCCULT LYMPH NODE TUMOR CELLS IN NODE-NEGATIVE GASTRIC CANCER PATIENTS ABCD: Arquivos Brasileiros de Cirurgia Digestiva Gastric cancer Micrometastasis Lymph node metastasis Immunohistochemistry. |
| title | DETECTION OF OCCULT LYMPH NODE TUMOR CELLS IN NODE-NEGATIVE GASTRIC CANCER PATIENTS |
| title_full | DETECTION OF OCCULT LYMPH NODE TUMOR CELLS IN NODE-NEGATIVE GASTRIC CANCER PATIENTS |
| title_fullStr | DETECTION OF OCCULT LYMPH NODE TUMOR CELLS IN NODE-NEGATIVE GASTRIC CANCER PATIENTS |
| title_full_unstemmed | DETECTION OF OCCULT LYMPH NODE TUMOR CELLS IN NODE-NEGATIVE GASTRIC CANCER PATIENTS |
| title_short | DETECTION OF OCCULT LYMPH NODE TUMOR CELLS IN NODE-NEGATIVE GASTRIC CANCER PATIENTS |
| title_sort | detection of occult lymph node tumor cells in node negative gastric cancer patients |
| topic | Gastric cancer Micrometastasis Lymph node metastasis Immunohistochemistry. |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202017000100030&tlng=en |
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