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KMID : 0371320040660050385
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Journal of the Korean Surgical Society
2004 Volume.66 No. 5 p.385 ~ p.390
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Identification of Lymph Node Micrometastases in Dukes´ B Colorectal Cancer Patients Using Monoclonal Antibodies against Cytokeratin-19
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Shin Eung-Jin
Kim Hyung-Chul
Lim Chul-Wan
Cho Gyu-Seok
Chu Chong-Woo
Baek Moo-Jun
Park Nae-Kyung
Jang Yong-Seog
Kim Jae-Joon
Song Ok-Pyung
Lee Min-Hyuk
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Abstract
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Purpose: The aims of this study were to immunohistochemically identify lymph node micormetastases in Dukes´ B colorectal cancer patients, and determine the relationship between lymph node micrometastases and other prognostic factors and recurrenee rates.
Methods: A retrospective analysis was conducted of 990 lymph nodes from Dukes´ B 42 patients who had undergone radical colorectal resection. These lymph nodes were immunohistochemically examined with monoclonal antibodies anainst cytokeratin-19. The prognostic factors and recurrent rates were compared between patients with and without lymph node micrometastases.
Results: Micrometastases were confirmed in 19 nodes (1.9%) from 9 patients (21.4%), No correlations were observed between micrometastases and the prognostic factors, with the exception of the preoperative CEA level. 8 of the 9 (88.9%) patients with micrometastases had preoperative CEA levels significalltly elevated above 5 ng/ml (P<0.0001). There were no significant differences in the recurrent rates (P=0.0572) between patients with and without micrometaslases during the short term follow up period (14.8 months) at the 95% confidence interval, but there were significant differences at the 90% confidence interval.
Conclusion: High preoperative CEA levels increase the risk for micrometastases, and the presence of micrometastases might increase the possibility of recurrence. Thus, a routine immunohistochemical technique for identifying micrometastases is recommended in the patients with a high preoperative CEA level. However, a more definite clinical significance of lymph node micrometastases awaits further extensive prospective studies.
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KEYWORD
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