Prognostic relevance of immunohistochemically detected lymph node micrometastasis in patients with gastric carcinoma

Eung Seok Lee, Yang Seok Chae, Insun Kim, Jongsang Choi, Bomwoo Yeom, Anthony S.Y. Leong

Research output: Contribution to journalArticle

78 Citations (Scopus)

Abstract

BACKGROUND. Micrometastases consisting of one to a few cells in lymph nodes resected during gastrectomy are difficult to identify using conventional hematoxylin and eosin (H&E) stains. It has been shown that immunostaining for cytokeratins is effective in detecting lymph node micrometastasis in a variety of human tumors, but only a few previous reports demonstrated its use in the treatment of patients with early and advanced gastric carcinoma, and those reports had conflicting results. METHODS. In this study, 3625 regional lymph nodes that were dissected in gastrectomy specimens from 153 patients with early-stage gastric carcinoma (46 patients) and advanced gastric carcinoma (107 patients) were immunostained with the anticytokeratin cocktail AE1/3 for micrometastasis (median, 23 lymph nodes; range, 8-66 lymph nodes). Micrometastasis (MM) was defined as a single tumor cell or clusters of tumor cells that were missed on conventional examination with H&E stains but were detected by immunostaining with broad-spectrum anticytokeratin antibodies. RESULTS. Lymph node metastasis (LNM) was detected in 609 lymph nodes (17%) by H&E staining. MM was identified in another 191 of the remaining lymph nodes (6.3%) from 75 patients. Twenty-eight of those patients were up-staged. There was a significant correlation between MM and depth of tumor invasion (P < 0.01). Patients with MM had a decreased 5-year survival rate (49%) compared with patients without MM (76%) for both early and advanced gastric carcinoma. The effect of MM on survival was most pronounced for patients in the Stage I and LNM negative group. CONCLUSIONS. Immunohistochemical examination using broad-spectrum anticytokeratin antibodies increased the detection rate of LNM and had a significant impact on staging and survival in patients with gastric carcinoma.

Original languageEnglish
Pages (from-to)2867-2873
Number of pages7
JournalCancer
Volume94
Issue number11
DOIs
Publication statusPublished - 2002 Jun 1

Fingerprint

Neoplasm Micrometastasis
Stomach
Lymph Nodes
Carcinoma
Gastrectomy
Neoplasm Metastasis
Neoplasms
Coloring Agents
Survival
Antibodies
Hematoxylin
Eosine Yellowish-(YS)
Keratins
Survival Rate
Staining and Labeling

Keywords

  • Advanced gastric carcinoma
  • Cytokeratin
  • Early gastric carcinoma
  • Immunohistochemistry
  • Lymph node metastasis
  • Micrometastasis
  • Prognosis
  • Survival

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Prognostic relevance of immunohistochemically detected lymph node micrometastasis in patients with gastric carcinoma. / Lee, Eung Seok; Chae, Yang Seok; Kim, Insun; Choi, Jongsang; Yeom, Bomwoo; Leong, Anthony S.Y.

In: Cancer, Vol. 94, No. 11, 01.06.2002, p. 2867-2873.

Research output: Contribution to journalArticle

Lee, Eung Seok ; Chae, Yang Seok ; Kim, Insun ; Choi, Jongsang ; Yeom, Bomwoo ; Leong, Anthony S.Y. / Prognostic relevance of immunohistochemically detected lymph node micrometastasis in patients with gastric carcinoma. In: Cancer. 2002 ; Vol. 94, No. 11. pp. 2867-2873.
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abstract = "BACKGROUND. Micrometastases consisting of one to a few cells in lymph nodes resected during gastrectomy are difficult to identify using conventional hematoxylin and eosin (H&E) stains. It has been shown that immunostaining for cytokeratins is effective in detecting lymph node micrometastasis in a variety of human tumors, but only a few previous reports demonstrated its use in the treatment of patients with early and advanced gastric carcinoma, and those reports had conflicting results. METHODS. In this study, 3625 regional lymph nodes that were dissected in gastrectomy specimens from 153 patients with early-stage gastric carcinoma (46 patients) and advanced gastric carcinoma (107 patients) were immunostained with the anticytokeratin cocktail AE1/3 for micrometastasis (median, 23 lymph nodes; range, 8-66 lymph nodes). Micrometastasis (MM) was defined as a single tumor cell or clusters of tumor cells that were missed on conventional examination with H&E stains but were detected by immunostaining with broad-spectrum anticytokeratin antibodies. RESULTS. Lymph node metastasis (LNM) was detected in 609 lymph nodes (17{\%}) by H&E staining. MM was identified in another 191 of the remaining lymph nodes (6.3{\%}) from 75 patients. Twenty-eight of those patients were up-staged. There was a significant correlation between MM and depth of tumor invasion (P < 0.01). Patients with MM had a decreased 5-year survival rate (49{\%}) compared with patients without MM (76{\%}) for both early and advanced gastric carcinoma. The effect of MM on survival was most pronounced for patients in the Stage I and LNM negative group. CONCLUSIONS. Immunohistochemical examination using broad-spectrum anticytokeratin antibodies increased the detection rate of LNM and had a significant impact on staging and survival in patients with gastric carcinoma.",
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T1 - Prognostic relevance of immunohistochemically detected lymph node micrometastasis in patients with gastric carcinoma

AU - Lee, Eung Seok

AU - Chae, Yang Seok

AU - Kim, Insun

AU - Choi, Jongsang

AU - Yeom, Bomwoo

AU - Leong, Anthony S.Y.

PY - 2002/6/1

Y1 - 2002/6/1

N2 - BACKGROUND. Micrometastases consisting of one to a few cells in lymph nodes resected during gastrectomy are difficult to identify using conventional hematoxylin and eosin (H&E) stains. It has been shown that immunostaining for cytokeratins is effective in detecting lymph node micrometastasis in a variety of human tumors, but only a few previous reports demonstrated its use in the treatment of patients with early and advanced gastric carcinoma, and those reports had conflicting results. METHODS. In this study, 3625 regional lymph nodes that were dissected in gastrectomy specimens from 153 patients with early-stage gastric carcinoma (46 patients) and advanced gastric carcinoma (107 patients) were immunostained with the anticytokeratin cocktail AE1/3 for micrometastasis (median, 23 lymph nodes; range, 8-66 lymph nodes). Micrometastasis (MM) was defined as a single tumor cell or clusters of tumor cells that were missed on conventional examination with H&E stains but were detected by immunostaining with broad-spectrum anticytokeratin antibodies. RESULTS. Lymph node metastasis (LNM) was detected in 609 lymph nodes (17%) by H&E staining. MM was identified in another 191 of the remaining lymph nodes (6.3%) from 75 patients. Twenty-eight of those patients were up-staged. There was a significant correlation between MM and depth of tumor invasion (P < 0.01). Patients with MM had a decreased 5-year survival rate (49%) compared with patients without MM (76%) for both early and advanced gastric carcinoma. The effect of MM on survival was most pronounced for patients in the Stage I and LNM negative group. CONCLUSIONS. Immunohistochemical examination using broad-spectrum anticytokeratin antibodies increased the detection rate of LNM and had a significant impact on staging and survival in patients with gastric carcinoma.

AB - BACKGROUND. Micrometastases consisting of one to a few cells in lymph nodes resected during gastrectomy are difficult to identify using conventional hematoxylin and eosin (H&E) stains. It has been shown that immunostaining for cytokeratins is effective in detecting lymph node micrometastasis in a variety of human tumors, but only a few previous reports demonstrated its use in the treatment of patients with early and advanced gastric carcinoma, and those reports had conflicting results. METHODS. In this study, 3625 regional lymph nodes that were dissected in gastrectomy specimens from 153 patients with early-stage gastric carcinoma (46 patients) and advanced gastric carcinoma (107 patients) were immunostained with the anticytokeratin cocktail AE1/3 for micrometastasis (median, 23 lymph nodes; range, 8-66 lymph nodes). Micrometastasis (MM) was defined as a single tumor cell or clusters of tumor cells that were missed on conventional examination with H&E stains but were detected by immunostaining with broad-spectrum anticytokeratin antibodies. RESULTS. Lymph node metastasis (LNM) was detected in 609 lymph nodes (17%) by H&E staining. MM was identified in another 191 of the remaining lymph nodes (6.3%) from 75 patients. Twenty-eight of those patients were up-staged. There was a significant correlation between MM and depth of tumor invasion (P < 0.01). Patients with MM had a decreased 5-year survival rate (49%) compared with patients without MM (76%) for both early and advanced gastric carcinoma. The effect of MM on survival was most pronounced for patients in the Stage I and LNM negative group. CONCLUSIONS. Immunohistochemical examination using broad-spectrum anticytokeratin antibodies increased the detection rate of LNM and had a significant impact on staging and survival in patients with gastric carcinoma.

KW - Advanced gastric carcinoma

KW - Cytokeratin

KW - Early gastric carcinoma

KW - Immunohistochemistry

KW - Lymph node metastasis

KW - Micrometastasis

KW - Prognosis

KW - Survival

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