Occult neoplastic cells in the lymph node sinuses and recurrence of primary breast, lung, esophageal, and gastric cancer.
The correlation between detection of occult neo-plastic cells (ONCs) in lymph node sinuses and the recurrence/metastasis of primary breast, lung, esophageal, and gastric cancer was examined. Among patients with Stage I-III cancer treated by radical resection with dissection of at least 10 lymph nodes, 40 patients who suffered recurrence/metastasis within 5 years post-operatively and 94 patients who did not have recurrence within 5 years were randomly selected. A total of 1,340 lymph nodes were subjected to immunohistochemical staining for cytokeratin to identify ONCs. Then the sensitivity, specificity, positive predictive value, and negative predictive value of ONCs were determined for predicting the recurrence of each cancer. These parameters were respectively 40.0, 75.9, 62.4, and 55.8% for breast cancer, while the respective values were 50.0, 77.4, 68.9, and 60.8% for lung, 57.1, 64.3, 61.5, and 60.0% for esophageal, and 68.8, 65.0, 66.3, and 67.5% for gastric cancer. All of the parameters exceeded 65% for gastric cancer. ONCs also showed a high specificity for breast and lung cancer, but both the sensitivity and specificity were low for esophageal cancer.
Mukai
Masaya
M
Department of Surgery, Tokai University Oiso Hospital, Gakyou 21-1, Oiso, Kanagawa 259-0198, Japan. colorectalmasaya@yahoo.co.jp
Sato
Shinkichi
S
Nakasaki
Hisao
H
Tajima
Takayuki
T
Saito
Yuuki
Y
Nishiumi
Noboru
N
Iwasaki
Masayuki
M
Tokuda
Yutaka
Y
Ogoshi
Kyoji
K
Inoue
Hiroshi
H
Makuuchi
Hiroyasu
H
D001943:Breast Neoplasms / Q000378:metabolism / Q000473:pathology; D004938:Esophageal Neoplasms / Q000378:metabolism / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D007633:Keratins / Q000032:analysis; D008175:Lung Neoplasms / Q000378:metabolism / Q000473:pathology; D008198:Lymph Nodes / Q000737:chemistry / Q000473:pathology*; D008207:Lymphatic Metastasis / Q000175:diagnosis*; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D009369:Neoplasms / Q000378:metabolism / Q000473:pathology*; D011237:Predictive Value of Tests; D011897:Random Allocation; D012680:Sensitivity and Specificity; D016037:Single-Blind Method; D013274:Stomach Neoplasms / Q000378:metabolism / Q000473:pathology
D007633:Keratins