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Colorectal Carcinoma liver Metastases : Immunohistochemical Detection of Hepatic Micrometastases Using Monoclonal Anticytokeratin Antibody

结直肠癌肝转移：使用单克隆抗细胞角蛋白抗体对肝微转移进行免疫组织化学检测

基本信息

批准号：
15591390
负责人：
SHIRAI Yoshio
金额：
$ 1.79万
依托单位：
NIIGATA UNIVERSITY
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2003
资助国家：
日本
起止时间：
2003 至 2004
项目状态：
已结题

项目摘要

BACKGROUND : Hepatic metastases from colorectal carcinoma frequently recur after resection and hepatic micrometastases most likely are important in the development of such recurrences. The objectives of the current study were to assess the feasibility of the immunohistochemical detection of hepatic micrometastases from colorectal carcinoma and to determine their clinical significance.METHODS : From January 1981 through December 2003,a total of 129 patients underwent curative hepatic resection for colorectal carcinoma metastases. Multiple tissue sections were cut from the advancing margin of the largest hepatic metastasis in each patient and were stained with an antibody against cytokeratin-20 to detect hepatic micrometastases, which were defined as discrete microscopic cancerous lesions surrounding the dominant metastasis. Proliferation of tumor cells in the hepatic micrometastases was assessed immunohistochemically with Ki-67 staining as an indicator of viability of the tumor cells. T … More he median follow-up period was 127 months.RESULTS : Normal hepatocytes and intrahepatic bile duct epithelia stained negative for cytokeratin-20 in all patients, whereas the largest hepatic tumors stained positive in 114 patients (88%). Among the 114 patients with hepatic tumors that were positive for cytokeratin-20,hepatic micrometastases (a total of 211 lesions) were found immunohistochemically in 77 patients (68%). The presence of hepatic micrometastases was associated with a larger number of macroscopic hepatic metastases (P=0.002) and patients with hepatic micrometastases were found to demonstrate a higher probability of intrahepatic recurrence (P<0.001) compared with those patients without hepatic micrometastases. In addition, patients with hepatic micrometastases demonstrated a worse survival (cumulative 10-year survival rate of 21%) compared with those patients without hepatic micrometastases (cumulative 10-year survival rate of 66%) (P<0.001). Most of the hepatic micrometastases detected (189 of 211 lesions,90%) stained positive for Ki-67.CONCLUSIONS : Immunohistochemical detection of hepatic micrometastases is feasible in patients with colorectal carcinoma liver metastases. Hepatic micrometastasis indicates widespread hepatic involvement and thus predicts an increased risk of intrahepatic recurrence after hepatic resection and a poorer patient prognosis. Most tumor cells in hepatic micrometastases appear to be viable. Less

背景技术背景：结直肠癌肝转移在切除术后经常复发，肝微转移很可能在这种复发的发展中起重要作用。本研究的目的是评估免疫组化检测结直肠癌肝微转移的可行性，并确定其临床意义。方法：从1981年1月至2003年12月，共129例患者进行根治性肝切除结直肠癌转移。从每例患者最大肝转移灶的前进边缘切取多个组织切片，并用抗细胞角蛋白-20抗体染色以检测肝微转移灶，肝微转移灶定义为主要转移灶周围的离散显微镜下癌性病变。肝微转移瘤中肿瘤细胞的增殖以Ki-67染色作为肿瘤细胞活力的指标进行化学评价。不 ...更多信息结果：所有患者的正常肝细胞和肝内胆管上皮细胞角蛋白-20均为阴性，而最大的肝肿瘤中有114例（88%）染色阳性。在114例细胞角蛋白20阳性的肝肿瘤患者中，77例（68%）经免疫组化发现肝微转移（共211个病灶）。肝微转移的存在与大量肉眼可见的肝转移有关（P=0.002），发现有肝微转移的患者与无肝微转移的患者相比，肝内复发的可能性更高（P<0.001）。有肝微转移者的10年生存率（21%）明显低于无肝微转移者（66%）（P<0.001）。211例肝微转移灶中189例（90%）Ki-67阳性。结论：免疫组化检测结直肠癌肝微转移是可行的。肝微转移表明广泛的肝脏受累，因此预测肝切除术后肝内复发的风险增加，患者预后较差。肝微转移瘤中的大多数肿瘤细胞似乎是活的。少