Clinical significance of immunohistochemically detected lymph node micrometastasis in patients with histologically node-negative esophageal carcinoma: a multi-institutional study
Clinical significance of immunohistochemically detected lymph node micrometastasis in patients with histologically node-negative esophageal carcinoma: a multi-institutional study
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组织学淋巴结阴性食管癌患者免疫组织化学检测淋巴结微转移的临床意义：一项多机构研究
DOI：
10.1007/s10388-006-0098-0
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发表时间：
2007
期刊：
影响因子：
2.4
通讯作者：
A. Yanagisawa
中科院分区：
文献类型：
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作者：
H. Shiozaki;Y. Fujiwara;T. Hirai;H. Matsubara;M. Mori;Tsutomu Nakamura;Y. Nakanishi;S. Natsugoe;T. Noguchi;S. Ozawa;Y. Shimada;Seiji Udagawa;H. Yamana;M. Yano;T. Yasuda;A. Yanagisawa
背景在食管癌中，免疫组织化学（IHC）检测淋巴结（LN）微转移的临床意义仍有争议。我们设计了这项多中心研究，以确定ihc检测LN微转移在食管癌中的临床意义。方法选取8家医院经组织病理学证实的164例ln阴性食管癌患者。所有机构都使用了类似的免疫组织结构技术，每个医院的一名研究人员以及对食管癌特别感兴趣的病理学家独立诊断了微转移。结果研究人员认为51例（31%）LN患者hc相关微转移阳性，病理人员认为25例（15%）LN患者hc相关微转移阳性。后一微转移进一步分为单一（n= 13）和群集（n= 12）免疫阳性ln。Kaplan-Meier分析显示，研究者诊断的微转移对预后无显著影响，而病理学家诊断的簇状微转移对预后有显著影响。结论我们推测，文献报道的免疫组化分析结果不一致的原因是微转移的定义不同，以及微转移诊断的主观性，即依赖于检查者。我们的多机构研究还表明，在通过免疫组化评估LN微转移时，应考虑免疫染色细胞的形态学方面，并且只有具有免疫组化阳性细胞簇的LN在食管癌中具有预后意义。
BackgroundIn esophageal carcinoma, the clinical significance of immunohistochemically (IHC)-detected lymph node (LN) micrometastasis is still controversial. We designed this multicenter study to determine the clinical significance of IHC-detected LN micrometastasis in esophageal carcinoma.MethodsThe subjects were 164 patients with histopathologically confirmed LN-negative esophageal carcinoma from eight hospitals. A similar IHC technique was used in all institutions, and micrometastasis was diagnosed by a researcher at each hospital as well as independently by pathologists with special interest in esophageal carcinoma.ResultsIHC-related micrometastasis in LN was considered positive in 51 (31%) patients by the researchers and in 25 (15%) by the pathologists. The latter micrometastases were further classified into a single (n= 13) and clusters (n= 12) of immunopositive-LN. Kaplan–Meier analysis showed that researcher-based diagnosis of micrometastasis had no significant impact on prognosis whereas the cluster-type micrometastasis diagnosed by pathologists had a significant impact on prognosis.ConclusionsWe speculate that the inconsistent results of IHC analyses reported in the literature are caused by the use of different definitions of micrometastasis and the subjective nature of diagnosis of micrometastasis, i.e., dependence on the examiner. Our multiinstitutional study also indicates that the morphological aspects of immunostained cells should be considered when assessing micrometastasis in LN by IHC and that only LN with clusters of IHC-positive cells are prognostically significant in esophageal carcinoma.
DOI：
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发表时间：
2003
期刊：
Am Surg. 69・7
影响因子：
--
作者：
Arigami T;Owaki T;Higashi H;Owaki T;衣裴勝彦;夏越祥次;蔵原弘;中別府良昭;夏越祥次;夏越祥次;中野静雄;瀬戸山徹郎;有上貴明;夏越祥次;上之園芳一;Nakano S.;Ishigami S.;Owaki T.;有馬豪男;中別府良昭;有馬豪男;上之園芳一;上之園芳一;中野静雄;Kurahara H;Higashi H;Ishigami S;Nakano S;Ishigami S;Sumikura S;Uenosono Y;Natsugoe S;Natsugoe S;Ishigami S;Ishigami S
通讯作者：
Ishigami S