Mapping of Sentinel Lymph Node Micrometastasis in Dukes-B Colorectal Carcinoma and Its Clinical Significance

OBJECTIVE To investigate the detection of sentinel lymph node (SLN) micrometastasis (MM) and the clinical significance in patients with Dukes-B colorectal carcinoma (CRC) using H&E stained slides. METHODS In a prospective study of 64 patients with DukesB CRC undergoing radical surgery, ro...

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Main Authors: Xiongfei YANG, Tao WANG, Weisheng ZHANG
Format: Article
Language:English
Published: China Anti-Cancer Association 2009-10-01
Series:Cancer Biology & Medicine
Subjects:
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author Xiongfei YANG
Tao WANG
Weisheng ZHANG
author_facet Xiongfei YANG
Tao WANG
Weisheng ZHANG
author_sort Xiongfei YANG
collection DOAJ
description OBJECTIVE To investigate the detection of sentinel lymph node (SLN) micrometastasis (MM) and the clinical significance in patients with Dukes-B colorectal carcinoma (CRC) using H&E stained slides. METHODS In a prospective study of 64 patients with DukesB CRC undergoing radical surgery, routine H&E staining combined with the immunohistochemical SP method was used to detect the expression of the cytokeratin 20 (CK20) and telomerase (TLMA) in 122 SLNs from 61 of the 64 cases. During a 3-year follow up, the patients’ clinicopathologic parameters data, survival and their relationship were collected and analyzed. RESULTS i) In 6 out of the 61 cases with successful mapping, 9 SLNs were positive after routine detection using H&E staining. ii ) In the other 55 with negative results from H&E staining, the positive rate of CK20 expression was 27.3% (15/55), and the positive rate of TLMA 21.8% (12/55), at er immunohistochemical examination (IHC) on the SLN. iii ) Detection by combining the 2 methods showed that the micrometastasis rate was 38.2% (21/55). iv ) The recurrence or metastasis rate of CRC was significantly higher in the Dukes-B patients with sentinel lymph node micrometastasis (SLNMM) (+) than in those with SLNMM (-) ( P < 0.05), and simultaneously, the survival rate decreased by a large margin in the patients with SLNMM (+), compared to those with SLNMM (-) (P < 0.05). There were significant differences in the recurrence or metastasis rate of cancer and the survival rate between the Dukes-B patients with SLNMM (-) and the Dukes-C patients (P < 0.05). CONCLUSION Examination of anti-CK20 and anti-TLMA using immunohistochemical staining can be used to detect SLNMM, and the combined examination of the 2 can increase the detection rate. The detection of SLNMM can precisely determine the Dukes stage of colorectal carcinoma, which is of help in directing postoperative adjunctive therapy and in assessing prognosis.
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spelling doaj.art-f1d90d392744456e9e3d68e910e470992022-12-22T01:04:56ZengChina Anti-Cancer AssociationCancer Biology & Medicine2095-39412009-10-016534735310.1007/s11805-009-0347-9Mapping of Sentinel Lymph Node Micrometastasis in Dukes-B Colorectal Carcinoma and Its Clinical SignificanceXiongfei YANGTao WANGWeisheng ZHANGOBJECTIVE To investigate the detection of sentinel lymph node (SLN) micrometastasis (MM) and the clinical significance in patients with Dukes-B colorectal carcinoma (CRC) using H&E stained slides. METHODS In a prospective study of 64 patients with DukesB CRC undergoing radical surgery, routine H&E staining combined with the immunohistochemical SP method was used to detect the expression of the cytokeratin 20 (CK20) and telomerase (TLMA) in 122 SLNs from 61 of the 64 cases. During a 3-year follow up, the patients’ clinicopathologic parameters data, survival and their relationship were collected and analyzed. RESULTS i) In 6 out of the 61 cases with successful mapping, 9 SLNs were positive after routine detection using H&E staining. ii ) In the other 55 with negative results from H&E staining, the positive rate of CK20 expression was 27.3% (15/55), and the positive rate of TLMA 21.8% (12/55), at er immunohistochemical examination (IHC) on the SLN. iii ) Detection by combining the 2 methods showed that the micrometastasis rate was 38.2% (21/55). iv ) The recurrence or metastasis rate of CRC was significantly higher in the Dukes-B patients with sentinel lymph node micrometastasis (SLNMM) (+) than in those with SLNMM (-) ( P < 0.05), and simultaneously, the survival rate decreased by a large margin in the patients with SLNMM (+), compared to those with SLNMM (-) (P < 0.05). There were significant differences in the recurrence or metastasis rate of cancer and the survival rate between the Dukes-B patients with SLNMM (-) and the Dukes-C patients (P < 0.05). CONCLUSION Examination of anti-CK20 and anti-TLMA using immunohistochemical staining can be used to detect SLNMM, and the combined examination of the 2 can increase the detection rate. The detection of SLNMM can precisely determine the Dukes stage of colorectal carcinoma, which is of help in directing postoperative adjunctive therapy and in assessing prognosis.colorectal carcinomasentinel lymph nodemicrometastasis.
spellingShingle Xiongfei YANG
Tao WANG
Weisheng ZHANG
Mapping of Sentinel Lymph Node Micrometastasis in Dukes-B Colorectal Carcinoma and Its Clinical Significance
Cancer Biology & Medicine
colorectal carcinoma
sentinel lymph node
micrometastasis.
title Mapping of Sentinel Lymph Node Micrometastasis in Dukes-B Colorectal Carcinoma and Its Clinical Significance
title_full Mapping of Sentinel Lymph Node Micrometastasis in Dukes-B Colorectal Carcinoma and Its Clinical Significance
title_fullStr Mapping of Sentinel Lymph Node Micrometastasis in Dukes-B Colorectal Carcinoma and Its Clinical Significance
title_full_unstemmed Mapping of Sentinel Lymph Node Micrometastasis in Dukes-B Colorectal Carcinoma and Its Clinical Significance
title_short Mapping of Sentinel Lymph Node Micrometastasis in Dukes-B Colorectal Carcinoma and Its Clinical Significance
title_sort mapping of sentinel lymph node micrometastasis in dukes b colorectal carcinoma and its clinical significance
topic colorectal carcinoma
sentinel lymph node
micrometastasis.
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AT taowang mappingofsentinellymphnodemicrometastasisindukesbcolorectalcarcinomaanditsclinicalsignificance
AT weishengzhang mappingofsentinellymphnodemicrometastasisindukesbcolorectalcarcinomaanditsclinicalsignificance