Sentinel node micrometastases have high proliferative potential in gastric cancer
Sentinel node micrometastases have high proliferative potential in gastric cancer
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DOI：
10.1016/j.jss.2007.04.037
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发表时间：
2008-04-01
影响因子：
2.2
通讯作者：
Aikou, Takashi
中科院分区：
文献类型：
--
作者：
Yanagita, Shigehiro;Natsugoe, Shoji;Aikou, Takashi
背景资料。第6版的TNM分类最近定义了“前哨淋巴结(SN)”、“微转移”和“孤立肿瘤细胞(ITC)”。本研究以胃癌的SNS为研究重点，研究了此类转移的频率和增殖活性。我们招募了133名患有CT1-2肿瘤的患者(CT1：104，CT2：29)，并绘制了SNS图。采用常规组织学方法和免疫组织化学方法检测淋巴结转移情况。用Ki-67抗体检测原发肿瘤和淋巴结转移情况，评价其增殖活性。转移性SNS患者19例，转移性SNS患者52例。大转移率为48%，微转移率为25%，ITC转移率为27%。Ki-67的表达与淋巴侵犯(P=0.0001)、静脉侵犯(P<；0.0001)和淋巴结转移(P<；0.0001)密切相关。96%的大转移癌、92%的微转移癌和29%的ITC细胞Ki-67阳性。我们发现SNS中的微转移和部分ITCs具有增殖活性。我们建议在明确其临床意义之前，尤其是在SN导航手术中，应切除微转移和ITCs。(C)2008 Elsevier Inc.保留所有权利。
Background. The 6th edition of the TNM classification has recently defined "sentinel nodes (SN)," "micrometastasis," and "isolated tumor cells (ITC)." The present study examines the frequency and proliferative activity of such metastases with focus on the SNs of gastric cancer.Methods. We enrolled 133 patients with cT1-2 tumors (cT1: 104, cT2: 29) and mapped SNs. Lymph node metastases were examined by routine histology and by immunohistochemistry with anti-cytokeratin. We used the Ki-67 antibody to detect the primary tumor and lymph node metastases to evaluate proliferative activity.Results. The number of patients with SNs metastases and metastatic SNs was 19 and 52, respectively. The frequencies of macrometastasis, micrometastasis, and ITC were 48%, 25%, and 27%, respectively. Ki-67 expression in the tumor closely correlated with lymphatic invasion (P = 0.0001), venous invasion (P < 0.0001), and lymph node metastasis (P < 0.0001). Cells in 96% of macrometastases, 92% of micrometastases, and 29%, of ITCs were Ki-67 positive.Conclusions. We showed that micrometastasis and some ITCs in SNs had proliferative activity. We suggest that micrometastasis and ITCs should be removed, especially during SN navigation surgery, until their clinical significance is clarified. (C) 2008 Elsevier Inc. All rights reserved.