title: Correlation between occult neoplastic cells in the lymph node sinuses and recurrence in patients with curatively resected Dukes' B colorectal cancer.
abstract: This study investigated whether it is possible to detect patients who have a high risk of metastasis and recurrence after resection of stage II Dukes' B primary colorectal cancer. Among 434 patients who underwent curative resection of primary colorectal cancer, 167 (38.5%) had Dukes' B cancer. Among them, 19 patients (11.4%) suffered from postoperative metastasis or recurrence. In 17 patients with recurrence who could be followed-up completely (recurrence group) and 17 other patients who survived for at least 5 years without recurrence (non-recurrence group), immunohistochemical staining of resected lymph nodes for cytokeratin (AE1/AE3 and CAM 5.2) was performed. AE1/AE3 was positive in 76.5% and 47.1% of the patients from the recurrence and non-recurrence groups, respectively, while CAM 5.2 was positive in 52.9% and 17.6%, respectively. There were no significant differences of either AE1/AE3 or CAM 5.2 positivity between the groups. However, the occult neoplastic cell count (mean +/- SD) floating in the lymph node sinuses was significantly higher in patients from the recurrence group who were positive for AE1/AE3 or CAM 5.2 than in patients from the non-recurrence group (6.12+/-6.00 vs. 0.59+/-0.71; p=0.0019 and 3.94+/-5.06 vs. 0.29+/-0.69; p=0.0098, respectively). These results suggest that patients with Dukes' B primary colorectal cancer who have a higher risk of recurrence can be selected by immunostaining of resected lymph nodes for cytokeratin.
authors.affiliation: Department of Surgery, Tokai University Oiso Hospital, Kanagawa 259-0198, Japan. colorectalmasaya@yahoo.co.jp
authors.forename: Masaya
authors.initials: M
authors.lastname: Mukai
authors.forename: Shinkichi
authors.initials: S
authors.lastname: Sato
authors.forename: Nobukazu
authors.initials: N
authors.lastname: Komatsu
authors.forename: Tomomi
authors.initials: T
authors.lastname: Nishida
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Shiba
authors.forename: Isao
authors.initials: I
authors.lastname: Ito
authors.forename: Hisao
authors.initials: H
authors.lastname: Nakasaki
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Makuuchi
mesh_terms: D000906:Antibodies / Q000737:chemistry; D015415:Biomarkers; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000378:metabolism* / Q000401:mortality; D006801:Humans; D007150:Immunohistochemistry; D007633:Keratins / Q000096:biosynthesis / Q000378:metabolism; D008207:Lymphatic Metastasis; D009362:Neoplasm Metastasis; D009382:Neoplasms, Unknown Primary / Q000401:mortality / Q000473:pathology*; D011379:Prognosis; D012008:Recurrence; D013997:Time Factors
chemical_list: D000906:Antibodies; D015415:Biomarkers; C400901:CAM 5.2 antigen; D007633:Keratins