No abstract available.
Neoplasm Micrometastasis* ; Stomach Neoplasms*

No abstract available.
Bone Marrow* ; Breast Neoplasms* ; Breast* ; Neoplasm Micrometastasis*

Recently, lymph node micrometastasis has been evaluated for its prognostic value in gastric cancer. Lymph node micrometastasis cannot be detected via a usual pathologic examination, but it can be detected by using some other techniques including immunohistochemistry and reverse transcription-polymerase chain reaction assay. With the development of such diagnostic techniques, the detection rate of lymph node micrometastasis is constantly increasing. Although the prognostic value of lymph node micrometastasis remains debatable, its clinical impact is apparently remarkable in both early and advanced gastric cancer. At present, studies on the prognostic value of lymph node micrometastasis are evolving to overcome its current limitations and extend the scope of its application.
Immunohistochemistry ; Lymph Nodes* ; Neoplasm Micrometastasis* ; Stomach Neoplasms*

There have been some controversies on prognostic significance of lymph node (LN) micrometastasis (MM) in advanced gastric carcinomas (AGCs). The present study aimed at 1) determination of prognostic significance of MM, 2) evaluation of the relationship between MM and clinicopathological parameters, and 3) determination of LN group where MMs were frequently found. We studied 70 cases of AGC without LN metastasis on initial examination. The tumors were examined for location, size, depth of invasion, differentiation, histologic type, lymphatic invasion, and c-erbB-2 expression. To evaluate MM, pancytokeratin immunohistochemistry was performed in all LNs from 70 cases of AGCs. Among 2,203 dissected LNs from 70 patients, 37 (1.6%) LNs from 19 (27.1%) patients revealed MM. Micrometastases were seen in only group 1 and 2 LNs: none had group 3 and 4 LN involvement. The gender, age, tumor size, location of tumor, histologic type, differentiation, depth of invasion, lymphatic invasion, and c-erbB-2 expression were not significantly associated with MM status. The survival time of the MM-positive group (mean: 62 months) was significantly shorter than that of the MM-negative group (mean: 72 months) (p=0.046). The findings of this study indicate that the presence of MM in LNs is an important prognostic factor in AGC patients.
Humans ; Immunohistochemistry ; Keratins ; Lymph Nodes* ; Neoplasm Metastasis ; Neoplasm Micrometastasis*

Gastric cancer is the most prevalent cancer in Korea and comprises the second cause of cancer death. Surgery only can provide chance of cure, but most locally advanced cancers recur after a curative resection, even though important advances in the surgical and nonsurgical treatments of gastric cancer have taken place. Preoperative chemotherapy theoretically can provide the advantages of reducing the bulk of tumor, which might improve the R0 resection rate, and of treating micrometastases early. Also, preoperative chemotherapy is expected to render unresectable tumors resectable without increasing postoperative morbidity and mortality. There are many new chemotherapeutic agents available for the treatment of advanced gastric cancer, but still the most effective agent, the optimal time and number of cycle for administration are still not known. The addition of postoperative chemotherapy through an intraperitoneal route and/or radiotherapy might affect the outcome of surgery favorably, but that hasn't been proved yet. A multicenter prospective randomized phase III trial should be performed to answer for those questions and to improve the curability of gastric cancer treatment.
Drug Therapy* ; Korea ; Mortality ; Neoplasm Micrometastasis ; Radiotherapy ; Stomach Neoplasms*

The current TNM staging including N staging has been suggested as a gold standard for the appropriate therapy in the well differentiated thyroid cancer patients. N staging was established based on histopathologic findings, however, the newly suggested prognostic factors for the revision of N staging include some clinicopathologic factors, such as clinical metastasis (macrometastasis), large node metastasis (> or =3 cm), extranodal extension and the number of metastatic node. Recently, American Thyroid Association reported the possibility that the low-risk group patients would be overestimated as high-risk group patients that leads to the overtreatment, the following unnecessary complication and the economic cost. The preexisting N1a/N1b classification by anatomical location of metastatic node still remains as a strong prognostic factor; however, many evidences indicated that the clinicopathologic factors described above should be considered in the risk stratification in the near future. Thus, it needs to be stressed that the four factors of micrometastasis, large node metastasis (> or =3 cm), gross or microscopic extranodal extension and multiple metastatic node (>5 cm) have been established as negative or positive prognostic factors and should be noted in clinical practice.
Humans ; Neoplasm Metastasis ; Neoplasm Micrometastasis ; Neoplasm Staging ; Thyroid Gland ; Thyroid Neoplasms

This review discusses the production of alpha-particle-emitting radionuclides in radioimmunotherapy. Radioimmunotherapy labeled with alpha-particle is expected to be very useful for the treatment of monocellular cancer (e.g. leukemia) and micrometastasis at an early stage, residual tumor remained in tissues after chemotherapy and tumor resection, due to the high linear energy transfer (LET) and the short path length in biological tissue of alpha particle. Despite of the expected effectiveness of alpha-particle in radioimmunotherapy, its clinical research has not been activated by the several reasons, shortage of a suitable a-particle development and a reliable radionuclide production and supply system, appropriate antibody and chelator development. Among them, the establishment of radionuclide development and supply system is a key factor to make an alpha-immunotherapy more popular in clinical trial. Alpha-emitter can be produced by several methods, natural radionuclides, reactor irradiation, cyclotron irradiation, generator system and elution. Due to the sharply increasing demand of 213Bi, which is a most promising radionuclide in radioimmunotherapy and now has been produced with reactor, the cyclotron production system should be developed urgently to meet the demand.
Alpha Particles ; Cyclotrons ; Drug Therapy ; Linear Energy Transfer ; Neoplasm Micrometastasis ; Neoplasm, Residual ; Radioimmunotherapy* ; Radioisotopes*

PURPOSE: Sentinel lymph node (SLN) biopsy is thought to be a highly accurate method of assessing axillary nodal status in breast cancer. Furthermore, it can improve axillary staging by providing a more detailed examination of selected lymph nodes with a high probability of metastasis rather than the entire axillary nodes. The purpose of this study was to assess the incidence of SLN micrometastasis in node-negative breast cancer. METHODS: SLN biopsy was performed in 40 patients with clinically node-negative breast cancer using vital blue dye and/or radioisotope methods; the blue dye method was used in 21 cases, the isotope method in 14 cases, and a combination of both methods in 5 cases. All lymph nodes were evaluated by routine pathologic examination, and a more detailed examination was performed on sentinel nodes in node-negative cases; sentinel nodes were serially sectioned at an interval of 40micrometer depth followed by H&E and cytokeratin immunohistochemical (IHC) staining. RESULTS: Sentinel nodes were detected in 35 of 40 patients (87.5%). The mapping technique used in the remaining 5 cases was vital blue dye method only. Axillary node metastasis was found in 16 of 40 patients. Sentinel node biopsy accurately reflected the axillary node status in all cases; the sensitivity, specificity, and overall accuracy were 100, 100 and 100%, respectively. In 11 of 16 node-positive patients (68.8%), sentinel nodes were the only metastatic nodes. Occult micrometastases were found in SLN by serial section and IHC staining in 4 of 19 patients diagnosed as node- negative by routine pathological examination (21.1%). Occult micrometastasis of SLN was not correlated with primary tumor size, histologic grade or lymphovascular invasion with the exception of the S-phase fraction (P=0.023). CONCLUSION: SLN biopsy was a highly accurate method of assessing axillary node metastasis in breast cancer. Serial sectioning and IHC staining of SLN were sensitive methods in the detection of occult lymph node metastasis.
Biopsy ; Breast Neoplasms* ; Breast* ; Humans ; Incidence ; Keratins ; Lymph Nodes* ; Neoplasm Metastasis ; Neoplasm Micrometastasis* ; Sensitivity and Specificity

PURPOSE: Sentinel lymph node (SLN) biopsy is thought to be a highly accurate method of assessing axillary nodal status in breast cancer. Furthermore, it can improve axillary staging by providing a more detailed examination of selected lymph nodes with a high probability of metastasis rather than the entire axillary nodes. The purpose of this study was to assess the incidence of SLN micrometastasis in node-negative breast cancer. METHODS: SLN biopsy was performed in 40 patients with clinically node-negative breast cancer using vital blue dye and/or radioisotope methods; the blue dye method was used in 21 cases, the isotope method in 14 cases, and a combination of both methods in 5 cases. All lymph nodes were evaluated by routine pathologic examination, and a more detailed examination was performed on sentinel nodes in node-negative cases; sentinel nodes were serially sectioned at an interval of 40micrometer depth followed by H&E and cytokeratin immunohistochemical (IHC) staining. RESULTS: Sentinel nodes were detected in 35 of 40 patients (87.5%). The mapping technique used in the remaining 5 cases was vital blue dye method only. Axillary node metastasis was found in 16 of 40 patients. Sentinel node biopsy accurately reflected the axillary node status in all cases; the sensitivity, specificity, and overall accuracy were 100, 100 and 100%, respectively. In 11 of 16 node-positive patients (68.8%), sentinel nodes were the only metastatic nodes. Occult micrometastases were found in SLN by serial section and IHC staining in 4 of 19 patients diagnosed as node- negative by routine pathological examination (21.1%). Occult micrometastasis of SLN was not correlated with primary tumor size, histologic grade or lymphovascular invasion with the exception of the S-phase fraction (P=0.023). CONCLUSION: SLN biopsy was a highly accurate method of assessing axillary node metastasis in breast cancer. Serial sectioning and IHC staining of SLN were sensitive methods in the detection of occult lymph node metastasis.
Biopsy ; Breast Neoplasms* ; Breast* ; Humans ; Incidence ; Keratins ; Lymph Nodes* ; Neoplasm Metastasis ; Neoplasm Micrometastasis* ; Sensitivity and Specificity

PURPOSE: Sentinel lymph node (SLN) biopsy has been shown to be accurate in axillary node staging in early breast cancer. If any SLN is positive, the standard care remains completion axillary node dissection (ALND). However over 50% of the patients with metastatic SLNs do not show other non-SLN metastasis. The purpose of this study was to identify predictors of non-SLN tumor involvement in patients with metastatic SLNs. METHODS: We reviewed 387 breast cancer patients in whom an SLN biopsy was successfully performed using a subareolar injection of 99mTc-Tin colloid. RESULTS: Among the reviewed patients, 83 patients showed positive SLNs, and subsequently underwent ALND. In 47 of 83 patients (56.6%), SLNs were the only metastatic nodes. The following factors were assessed for predictors of non- SLN metastasis: age of the patient, size, grade, histologic type, multicentricity of the primary tumor, number of SLNs removed, number of ositive SLNs, number of negative SLNs, size of the SLN metastasis, percentage of SLNs replaced by metastasis, and extracapsular extension (ECE). By multi-variate analysis, the size of SLN metastasis (<2 mm), absence of ECE, and the percent replacement (.10%) were negative predictors of non-SLN metastasis. Among 18 cases in which micrometastasis were found in the SLNs, additional metastasis in non-SLN has been found in 3 cases. This result suggests that micro-metastasis in a SLN is not a sufficient condition for not performing ALND. However, in 9 cases, in which all of three factors (micrometastasis, absence of ECE, no more than 10% replacement of SLNs by tumor cells) were present, additional metastasis had not been found in the non-SLNs. CONCLUSION: Although further study is needed to verify the result, it would seem that the presence of all three factors (micrometastasis, absence of ECE, no more than 10% replace- ment of SLNs by tumor cells) in combination might be sufficient to safely omit ALND.
Biopsy ; Breast Neoplasms* ; Breast* ; Colloids ; Humans ; Lymph Nodes* ; Neoplasm Metastasis* ; Neoplasm Micrometastasis