Immunohistochemical Assay for Lymph-Node Micrometastasis in Gastric Cancer and Correlation with Survival Rate.
- Author:
Kyung Kyu PARK
1
;
Chul MOON
;
Moon Soo LEE
;
Kyung Yul HUR
;
Yong Seog JANG
;
Jae Joon KIM
;
Min Hyuk LEE
;
So Young JIN
;
Dong Wha LEE
Author Information
- Publication Type:Original Article
- Keywords: Gastric cancer; Lymph-node micrometastasis; Prognostic indicator
- MeSH: Classification; Eosine Yellowish-(YS); Hematoxylin; Humans; Incidence; Keratins; Life Tables; Lymph Nodes; Multivariate Analysis; Neoplasm Micrometastasis*; Prognosis; Proportional Hazards Models; Retrospective Studies; Stomach Neoplasms*; Survival Rate*
- From:Journal of the Korean Gastric Cancer Association 2002;2(1):5-11
- CountryRepublic of Korea
- Language:Korean
- Abstract: PURPOSE: The purpose of this study is to identify immunohistochemical evidence of lymph-node micrometastasis in histologic node-negative gastric cancer patients and to evaluate the prognostic significance of lymph-node micrometastasis. MATERIALS AND METHODS: A retrospective study of 50 gastric cancer patients who underwent curative resections from October 1990 to November 1994 was performed. Two consecutive sections were prepared: one for ordinary hematoxylin and eosin staining, and the other for immunohistochemical staining with Pan cytokeratin antibody (Novocastra, UK). In the univariate analysis, the survival rate was calculated using the Life Table Method, and the multivariate analysis was determined using a Cox Proportional Hazards Model. The statistical analyses of the relationships between the clinicopathologic factors and micrometastases were performed by using a Chi-square test. RESULTS: Of 2522 harvested lymph nodes, 81 (4.1%) nodes and 19 (38%) of 50 patients were identified as having lymph- node micrometastases by using immunohistochemical staining for cytokeratin. The incidence of lymph-node micrometastases was significantly higher in diffuse type carcinomas (54%, P=0.024) and in patients with serosal invasion (52.2%, P=0.05). For patients with lymph-node micrometastases (n=19), the 5-year survival rate was significantly decreased (73.7%, P=0.015). The Lauren's classification (P= 0.021) and the depth of invasion (P=0.035) were shown by multivariate analysis to have a significant relationship with the presence of micrometastases. Multivariate analysis revealed that lymph-node micrometastasis was independently correlated with survival in histologic node-negative gastric cancer patients. CONCLUSION: The presence of cytokeratin detected lymph-node micrometastases correlates with the worse prognosis for patients with histologic node-negative gastric cancer.
