Detection of pelvic lymph node micrometastasis in stage IA2-IB2 cervical cancer by immunohistochemical analysis
Detection of pelvic lymph node micrometastasis in stage IA2-IB2 cervical cancer by immunohistochemical analysis
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DOI：
10.1016/j.ygyno.2003.11.033
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发表时间：
2004-04-01
影响因子：
4.7
通讯作者：
Husain, A
中科院分区：
文献类型：
--
作者：
Juretzka, MM;Jensen, KC;Husain, A
Objective.本研究的目的是（1）通过免疫组化分析确定宫颈癌淋巴结微转移的发生率和（2）确定微转移的存在是否是早期宫颈癌预后不良的特征。我们回顾性分析了1990年至2000年在斯坦福大学医院接受根治性子宫切除术和淋巴结清扫术治疗的62例FIGO IA 2-IB 2期宫颈癌患者的病历。确定了49例淋巴结阴性患者。对976例经福尔马林固定、石蜡包埋的盆腔淋巴结切除标本进行连续切片，用抗细胞角蛋白抗体AE 1和AE 1/CAM 5.2染色。6例患者患有IA 2期疾病，37例患有IB 1期，6例患有IB 2期。患者的平均年龄为44岁（范围，24-76岁）。71%的患者患有鳞状细胞癌，22%患有腺癌，6%患有其他类型。在49例患者中的4例（8.1%）中检测到淋巴结微转移，包括检查的976个盆腔淋巴结中的4个（0.41%）。45例淋巴结阴性患者中12例（15.6%）有淋巴管间隙浸润（LVSI），而4例微转移患者中3例（75%）有LVSI。平均随访39.4个月，4例有微转移的患者中有2例（50%）复发，而45例无微转移的患者中有3例（6.7%）复发。这些初步数据表明，盆腔淋巴结的免疫组化检测在LVSI患者中更常见，并且可以识别需要辅助放化疗的患者。(C)2004年爱思唯尔公司All rights reserved.
Objective. The objectives of this study were to (1) determine the incidence of lymph node micrometastasis in cervical cancer by immunohistochemical analysis and (2) determine if the presence of micrometastasis is a poor prognostic feature in early cervical cancer.Methods. We retrospectively reviewed the medical records of 62 patients who underwent radical hysterectomy and lymphadenectomy for FIGO stage IA2-IB2 cervical cancer at Stanford University Hospital from 1990 to 2000. Forty-nine patients with negative lymph nodes were identified. A total of 976 formalin-fixed paraffin-embedded pelvic lymphadenectomy specimens were serially sectioned and stained with anti-cytokeratin antibodies AE1 and AE1/CAM5.2.Results. Six patients had stage IA2 disease, 37 had stage IB1, and 6 had IB2. The mean age of the patients was 44 years (range, 24-76). Seventy-one percent had squamous cell carcinomas, 22% had adenocarcinomas, and 6% had other types. Lymph node micrometastases were immunohistochemically detected in 4 of the 49 (8.1%) patients, comprising 4 of 976 (0.41%) pelvic lymph nodes examined. Twelve of 45 (15.6%) patients with negative nodes had lymph-vascular space invasion (LVSI) whereas 3 of 4 (75%) patients with micrometastases had LVSI. At a mean follow-up time of 39.4 months, 2 of 4 (50%) patients with micrometastasis had recurrent disease, while 3 of 45 (6.7%) patients without micrometastasis developed recurrent disease.Conclusions. These preliminary data suggest that immunohistochemical detection of pelvic lymph nodes is more frequent in patients with LVSI and may identify patients needing adjuvant chemoradiation. (C) 2004 Elsevier Inc. All rights reserved.