Establishment of rapid molecular diagnoses of micrometastases of sentinel lymph node and its clinical application

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Our study has revealed that ; 1. Identification of sentinel lymph node (SLN) used as index of expansion at time of operation of digestive organ cancer or reduction of lymph nodes dissection, 2. Diagnosis of micrometastases of SLN, 3. Development of rapid gene-diagnosis method while surgical operation, 4. Evaluation of influence of SLN affection on prognosis.1. Identification of sentinel lymph node (SLN) used as index of expansion at time of digestive organ cancer operation, or reduction of lymph nodes dissection.The conventional pathological diagnosis estimated the micrometastases situation of 30 cases that were lymph node metastases negative among 52 stomach cancer cases. The result in which #7 lymph node may reflect other 2 group lymph node may reflect other 2 group lymph nodes metastases situations in evaluation whether #7 lymph node may serve as SLN was obtaind (rate of false negative : 16.7 % and rate of accuracy : 88.9 %).2. Diagnosis of micrometastases of SLNThe hematoxylin-eosi … More n (HE) staining, the immunohistochemistry, and RT-PCR method have been examined. Then, it succeeded in raising the rate of detection of the cases, that is positive of metastases of SLN using together evaluation by the immunohistochemistry and RT-PCR method in addition to evaluation only using the conventional HE staining method (16 rate of SLN identification : 95→98 % ; Int. J. Oncol. 2000).3. Development of rapid molecular diagnosis method while surgical operation.It had required for obtaining a diagnostic result of the gene diagnosis using the conventional RT-PCR method for about 8 hours. We succeeded in shortening about 75 minutes and time, although a diagnostic result is obtained by an improvement of a RNA sampling process and introduction of real time PCR at present. When the technique from a new RNA sampling process to cDNA composition and delection by the real-time PCR method is now under establishment, it is presumed that it will be about 50 minutes obtaining a diagnostic result.4. Evaluation of influence SLN affects prognosisAnalysis about the metastases situation (it diagnoses in RT-PCR method) of #7 lymph node was performed about 28 cases in which were the clinical stage I and II performed curability A resection among 52 stomach cancer cases. It revealed that the cases of #7 lymph node metastases positive become poor prognosis compared with negative cases. Less