Impact of lymph node micrometastasis in hilar bile duct carcinoma patients.
OBJECTIVE
To immunohistochemically examine micrometastasis and VEGF-C expression in hilar bile duct carcinoma (HBDC) and to evaluate the clinical significance of the results.


METHODS
A total of 361 regional lymph nodes from 25 patients with node-negative HBDC were immunostained with an antibody against cytokeratins 8 and 18 (CAM 5.2), and immunohistochemical staining of VEGF-C was performed in 34 primary resected tumors.


RESULTS
Lymph node micrometastasis was detected in 6 (24%) of the 25 patients and 10 (2.8%) of the 361 lymph nodes. Patients with micrometastasis showed significantly poorer survival rates than those without (P = 0.025). VEGF-C expression was positive in 17 (50%) of 34 HBDC, and significantly correlated with lymph node metastasis (P = 0.042) and microscopic venous invasion (P = 0.035).


CONCLUSIONS
It is suggested that immunohistochemically detected lymph node micrometastasis has an impact on the outcome of HBDC. VEGF-C expression is highly correlated with lymph node metastasis in HBDC and might therefore be a useful predictor.
Taniguchi
Kentaro
K
First Department of Surgery, Mie University School of Medicine, Tsu City, Mie Prefecture, Japan. taniken@clin.medic.mie-u.ac.jp
Iida
Taku
T
Hori
Tomohide
T
Yagi
Shintaro
S
Imai
Hiroshi
H
Shiraishi
Taizo
T
Uemoto
Shinji
S