Identification of occult micrometastases in patients with early gastric cancer using anti-cytokeratin monoclonal antibodies.
The presence of occult micrometastases was evaluated in 1488 lymph nodes removed from 139 patients with node-negative early gastric cancer (EGC). Additional multiple levels of the lymph nodes were examined with haematoxylin-eosin staining and keratin immunostaining. Occult nodal micrometastases were detected in 24 patients (17%) in one or more lymph nodes dissected after a gastrectomy. The cases investigated were a small group from a total of 412 EGC patients who underwent surgical treatment in our hospital between 1976 and 1997; the mean follow-up period was 9 years (range 1-22). We found no significant differences between cytokeratin-negative and positive patients regarding the following clinicopathological parameters: age, gender, tumour size and site, macroscopic and microscopic type, depth of invasion and type of infiltration, according to Kodama's classification. The survival rate at 5 years was 88% and 87% for cytokeratin-negative and positive patients, respectively (log-rank = 0.6; ns). Our data suggest that occult micrometastases do not add useful information and immunohistochemical studies to detect them are probably unnecessary.
Saragoni
L
L
Department of Pathology, Hospital L. Pierantoni, Vecchiazzano, Forli 47100, Italy.
Gaudio
M
M
Morgagni
P
P
Folli
S
S
Bazzocchi
F
F
Scarpi
E
E
Saragoni
A
A
D000368:Aged; D000911:Antibodies, Monoclonal; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy; D006801:Humans; D007633:Keratins / Q000032:analysis*; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis / Q000473:pathology*; D008297:Male; D009362:Neoplasm Metastasis / Q000473:pathology; D011379:Prognosis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D015996:Survival Rate; D013997:Time Factors
D000911:Antibodies, Monoclonal; D007633:Keratins