Lymph node metastasis from gastric cancer is one of the most important events in the progress of disease, which may reflect the disease situation and contribute to evaluate accurately prognosis. Although the detailed mechanism of lymph node metastasis from gastric cancer has not been clearly elucidated, nodal metastasis comprise of a series of events involving the alterations of tumor biological characteristics, including changes of cancer cell proliferation, invasion, chemotaxis, and pathway of lymphatic drainage. As we know, assessment of lymph node metastatic status is significantly associated with both therapeutic strategy and prognostic prediction, It is controversial to adopt the optimal category of lymph node metastasis in clinical practice. Category based on the number of lymph node metastasis (e.g. N stage of UICC TNM classification) is considered as a prominent variable to apply for gastric cancer worldwide, nevertheless, category based on extent of lymph node metastasis (e.g. N stage of JGCA classification) is capable of contributing to the appropriate surgical procedure for patients. It has not reached a consensus for the assessment impacts of several special variables on prognostic evaluation in gastric cancer, including nodal micrometastasis, isolated tumor cells (ITCs) in lymph nodes, and skipping metastasis of lymph nodes, which needs further investigations to determining the application values in gastric cancer.
Cell Proliferation ; Humans ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Neoplasm Micrometastasis ; Neoplasm Staging ; Prognosis ; Stomach Neoplasms ; pathology

The sentinel lymph node (SLN) is defined as the lymph node(s) first receiving lymphatic drainage from the site of primary tumor. The application of SLN navigation surgery has been widely confirmed in both melanoma and breast cancer. In recent years, the concept of SLN has gained high attention in gastrointestinal tumors. However, the validity and feasibility of the SLN concept remains controversial for esophageal cancer due to its special anatomical sites and lymphatic drainage pathways. Lymph node micrometastasis is an important prognostic factor in esophageal cancer patients without lymph node metastasis. Detection of micrometastases in SLN of esophageal cancer plays an important role in determining the treatment options. In this article, we make a brief discussion on the application of SLN biopsy in esophageal surgery and explain its clinical significance.
Esophageal Neoplasms ; pathology ; surgery ; Humans ; Neoplasm Micrometastasis ; Sentinel Lymph Node Biopsy

BACKGROUND: Decision in mediastinal lymph node involvement of lung cancer by CT scan is very important and valuable for the treatment planning and prognosis prediction. In general, long diameter of mediastinal lymph node more than 15mm is used as criterion of lung cancer involvement. Adenocarcinoma has a tendency of early distant metastasis and micrometastasis, so adenocarcinoma may involve lymph node earlier and cannot be detected before lymph nodes are enlarged enough. The authors tried to determine the difference between two size criteria (15mm, 10mm) in adenocarcinoma for the detection of cancer involvement. METHODS: Numbers of sample are 60 cases (male 46, female 14, median age: 61.5 years). According to pathology, squamous cancer 41, large cell cancer 2, adenocarcinoma 17. According to TNM stage, I 23, II 24, IIIA 13. RESULTS: Mean long diameter of lymph node involvement is 16.0(+/-8.0) mm in non-adenocarcinoma group, and that of adenocarcinoma group is 12.0(+/-3.2) mm(p<0.05). If long diameter of lymph node larger than 15mm as involvement criterion is applied, sensitivity, specificity, positive predictive index, negative predictive index, accuracy of nonadenocarcinoma group are 54%, 100%, 100%, 83%, 86%, and those of adenocarcinoma group are 43%, 90%, 75%, 69%, 71%. If long diameter of lymph node larger than 10mm as involvement criterion is applied, sensitivity, specificity, positive predictive index, negative predictive index, accuracy of nonadenocarcinoma group are 65%, 77%, 61%, 92%, 79%, and those of adenocarcinoma group are 100%, 80%, 78%, 100%, 88%. CONCLUSION: Long diameter of lymph node larger than 10mm is more valuable criterion as lymph node involvement in adenocarcinoma of lungs.
Adenocarcinoma* ; Female ; Humans ; Lung Neoplasms ; Lung* ; Lymph Nodes* ; Neoplasm Metastasis ; Neoplasm Micrometastasis ; Pathology ; Prognosis ; Tomography, X-Ray Computed

BACKGROUND: Decision in mediastinal lymph node involvement of lung cancer by CT scan is very important and valuable for the treatment planning and prognosis prediction. In general, long diameter of mediastinal lymph node more than 15mm is used as criterion of lung cancer involvement. Adenocarcinoma has a tendency of early distant metastasis and micrometastasis, so adenocarcinoma may involve lymph node earlier and cannot be detected before lymph nodes are enlarged enough. The authors tried to determine the difference between two size criteria (15mm, 10mm) in adenocarcinoma for the detection of cancer involvement. METHODS: Numbers of sample are 60 cases (male 46, female 14, median age: 61.5 years). According to pathology, squamous cancer 41, large cell cancer 2, adenocarcinoma 17. According to TNM stage, I 23, II 24, IIIA 13. RESULTS: Mean long diameter of lymph node involvement is 16.0(+/-8.0) mm in non-adenocarcinoma group, and that of adenocarcinoma group is 12.0(+/-3.2) mm(p<0.05). If long diameter of lymph node larger than 15mm as involvement criterion is applied, sensitivity, specificity, positive predictive index, negative predictive index, accuracy of nonadenocarcinoma group are 54%, 100%, 100%, 83%, 86%, and those of adenocarcinoma group are 43%, 90%, 75%, 69%, 71%. If long diameter of lymph node larger than 10mm as involvement criterion is applied, sensitivity, specificity, positive predictive index, negative predictive index, accuracy of nonadenocarcinoma group are 65%, 77%, 61%, 92%, 79%, and those of adenocarcinoma group are 100%, 80%, 78%, 100%, 88%. CONCLUSION: Long diameter of lymph node larger than 10mm is more valuable criterion as lymph node involvement in adenocarcinoma of lungs.
Adenocarcinoma* ; Female ; Humans ; Lung Neoplasms ; Lung* ; Lymph Nodes* ; Neoplasm Metastasis ; Neoplasm Micrometastasis ; Pathology ; Prognosis ; Tomography, X-Ray Computed

OBJECTIVETo analyse the correlation between the micrometastasis and early recurrence and prognosis in laryngeal cancer.

METHODSTotal of 126 patients with laryngeal squamous cell carcinoma were included in the study. The micrometastasis was detected with hematoxylin and eosin staining (HE) and immunohistochemical staining for cytokeratin (CK) of the lymph node specimens after selective neck dissection (II-IV). Chi-square test was used to analyse the relationship between the micrometastasis and early recurrence and prognosis, and Kaplan-Meier method was used for survival analysis.

RESULTSHE staining showed positive micrometastasis in 41 cases and negative micrometastasis in 85 cases in which 33 cases were positive staining for CK. With a following-up of mean 6.3 years, recurrence or metastasis occurred in 15 cases with positive micrometastasis detected by HE staining, 14 cases with CK positive staining and 4 cases with CK negative staining. The correlation between micrometastasis and early recurrence was significant (P < 0.01). The total 5-year survival rate was 79.8%, 10-year survival rate was 60.5%. The 10-year survival rate (52.1%) of the patients with CK positive staining indicating micrometastasis was significantly higher than that of CK negative patients (81.2%, P < 0.01).

CONCLUSIONCervical micrometastasis predicts poor prognosis and early recurrence in patients with laryngeal squamous cell carcinoma.

Aged ; Carcinoma, Squamous Cell ; diagnosis ; pathology ; Female ; Humans ; Laryngeal Neoplasms ; diagnosis ; pathology ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Micrometastasis ; diagnosis ; pathology ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Prognosis

The incidence and mortality of lung cancer rank top in China. One important factor is the occurrence of metastasis. With the development of science technology, the effect of surgical treatment on lung cancer is improved. Moreover, the use of targeted therapy has achieved a new height for the treatment of lung cancer. However, the recurrence rate remains high even the tumor was completely resected at early stage. The occurrence of lymph node micrometastasis is considered as one of the plausible explanations. The difficulty indetecting micrometastasis has been greatly reduced. Although studies dig deeper into the lymph node micrometastasis, there are still some controversies including the selection of surgical procedures, the pathological staging and prognosis about patients with lymph node micrometastasis. This review manages to generalize the latest research progress of lymph node micrometastasis.
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Biomarkers, Tumor ; metabolism ; Carcinoma, Non-Small-Cell Lung ; metabolism ; pathology ; Humans ; Lung Neoplasms ; metabolism ; pathology ; Neoplasm Micrometastasis ; Risk Factors

OBJECTIVETo study the metastasis and micrometastasis in No.14v lymph nodes in patients with lower third gastric cancer.

METHODSA retrospective study was performed. A total of 53 patients undergoing radical resections by a single surgeon for lower third gastric cancer in the Department of General Surgery at the Affiliated Hospital of Qingdao Medical College were included. Conventional pathological section was used to detect lymph nodes metastasis and telomere TRAP-ELISA was used to identify the micrometastasis in No.14v lymph nodes.

RESULTSA total of 96 lymph nodes were dissected from the No.14v group and lymph nodes metastasis were discovered in 9 patients by conventional pathological section. Forty-four patients had no metastasis on conventional pathological examination, of whom 13(29.6%) were found to have micrometastasis. The overall metastatic rate was 41.5%(22/53). Metastasis and micrometastasis in the No.14v lymph nodes were associated with Borrmann types, depth of invasion, No.6 lymph nodes metastasis, tumor diameter, and TNM staging(P<0.05).

CONCLUSIONSNo.14v lymph nodes in patients with lower third gastric cancer is associated with a high incidence of metastasis and micrometastasis. The status of No.6 lymph nodes may be used as an useful indicator for No.14v lymph nodes metastases during the operation.

Adult ; Aged ; Female ; Humans ; Lymph Node Excision ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; pathology ; Male ; Middle Aged ; Neoplasm Micrometastasis ; pathology ; Retrospective Studies ; Stomach Neoplasms ; pathology ; surgery

PURPOSE: Sentinel lymph node (SLN) biopsy (SLNB) is widely performed for axillary staging in patients with breast cancer. Based on the results of frozen section examination (FSE), surgeons can decide to continue further axillary dissections. This study aimed to verify the accuracy of FSE for SLNs. METHODS: We reviewed the records of 4,219 patients who underwent SLNB for primary invasive breast cancer between 2007 and 2016 at the Severance Hospital. We evaluated factors associated with the false-negative results of FSE for SLNs using the Generalized Estimating Equations model. RESULTS: A total of 1,397 SLNs from 908 patients were confirmed to be metastatic. Seventy-one patients (1.7%) had confirmed pathologic N2 or N3 stage. Among metastatic SLNs, micrometastasis was found in 234 (16.8%). The overall accuracy of SLNB was 98.5%. The sensitivity and false-negative rate of FSE were 86.4% and 13.6%, respectively. Several clinicopathological factors, including the size of SLN metastases, suspicious preoperative axillary lymph nodes, and luminal B subtype, were associated with a higher rate of false-negative results. CONCLUSION: Most patients were not indicated for axillary lymph node dissection. Some patients may show transition in their permanent pathology due to the size of the metastatic node. However, the false-negative results of FSE for SLNs based on the size of the metastatic node did not change our practice. Therefore, intraoperative FSE for SLN should not be routinely performed for all breast cancer patients.
Biopsy ; Breast Neoplasms ; Breast ; False Negative Reactions ; Frozen Sections ; Humans ; Lymph Node Excision ; Lymph Nodes ; Neoplasm Metastasis ; Neoplasm Micrometastasis ; Pathology ; Phenobarbital ; Sentinel Lymph Node Biopsy ; Surgeons

The sentinel lymph node (SLN) is the first node receiving lymphatic drainage of a tumor and best reflects tumor metastasis. Whether there is a micrometastasis in SLN determines the choice of pelvic lymph node dissection for prostate cancer and is closely related to later treatment and prognosis. Therefore, precise localization of SLN is essential. This review discusses the application of SLN tracer techniques, such as preoperative imaging and intraoperative lymphoscintigraphy and localization of SLN, in prostate cancer.
Humans ; Lymph Node Excision ; Lymphatic Metastasis ; Lymphoscintigraphy ; Male ; Neoplasm Micrometastasis ; diagnostic imaging ; pathology ; Prognosis ; Prostatic Neoplasms ; pathology ; Sentinel Lymph Node ; diagnostic imaging

OBJECTIVETo investigate the relationship of vascular endothelial growth factor C (VEGF-C) and induced nitride oxide synthesizase (iNOS) expression in lymph node micrometastasis of oral squamous cell carcinoma.

METHODSSamples were obtained from 47 cases of oral squamous cell carcinoma and 15 cases with normal oral mucosa, VEGF-C and iNOS mRNA expression were detected by RT-PCR method. Lymph node micrometastasis of 10 normal lymph nodes and 355 lymph nodes from 47 cases of oral squamous cell carcinoma was detected with immunohistochemical reaction in cytokeratin antibody.

RESULTSThe percentages in tumors with higher expression were 57.4% for VEGF-C, 68.1% for iNOS (P < 0.05). They were significantly higher than that of normal groups. Significant positive relationship was found between VEGF-C and iNOS (P < 0.01). The positive rate of cytokeratin (CK) was 48.9%. Significant positive relationship was found between VEGF-C and CK, iNOS and CK (P < 0.01). The expression rates of CK in positive group of VEGF-C and iNOS were 63.0%, 65.6% respectively, and were significant higher than negative groups.

CONCLUSIONExpression of VEGF-C and iNOS in lymph node micrometastasis of oral squamous cell carcinoma is significant related.

Carcinoma, Squamous Cell ; metabolism ; pathology ; Humans ; Keratins ; metabolism ; Lymphatic Metastasis ; Mouth Neoplasms ; metabolism ; pathology ; Neoplasm Micrometastasis ; Nitric Oxide Synthase Type II ; metabolism ; Vascular Endothelial Growth Factor C ; metabolism