title: [Clinical pathological study on nodal micrometastases of non-small-cell lung cancer].
abstract: OBJECTIVE
  To investigate the practicability of detecting the micrometastases in lymph nodes of no-small-cell lung cancer (NSCLC) by means of the immunohistochemical (IHC) staining.
  
  
  METHODS
  The lymph node samples were taken from the patients with NSCLC during the operations. Firstly, each resulting tissue block was processed for routine paraffin embedding. Then the 6 approximately 10 serial sections were chosen, each 5 microm thick, from every paraffin block of the lymph node. Finally, the first and the second last sections of each lymph node were stained by hematoxylin eosin (HE), and the other serial sections were used for the IHC staining examination with the monoclonal antibody against cytokeratin 19.
  
  
  RESULTS
  The paraffin embedded sections of 195 regional lymph nodes from 25 patients with NSCLC were examined by HE staining. Thirty lymph nodes in 9 patients revealed gross nodal metastases, and none of lymph node in 25 patients showed micrometastatic tumor cells. Frozen tissue sections from 135 regional lymph nodes that were staged as free of metastases by HE staining were screened by IHC staining. Thirty-one lymph nodes in 9 patients showed micrometastatic tumor cells. Five of sixteen patients staged as PN(0) had hilum lymph nodal micrometastases, versus four of nine patients with stage PN(1) had mediastinal lymph nodal micrometastases. There was a significant difference between two groups (chi(2)=52.900, P=0.0193).
  
  
  CONCLUSIONS
  Conventional HE staining can accurately detect gross nodal metastases in the lymph nodes of patients with NSCLC, but is unfit for detecting lymph nodal micrometastases. IHC staining analysis can significantly facilitate the detection of occult micrometastatic tumor cells in lymph nodes of NSCLC, and its assessment of nodal micrometastases can provide a refinement of TNM stage for partial patients with stage I to II NSCLC.
authors.affiliation: Department of Thoracic Surgery, General Hospital of Chinese People's Liberation Army, Beijing 100853, China. wang_yunxi301@sina.com
authors.forename: Yun-xi
authors.initials: YX
authors.lastname: Wang
authors.forename: Xiang-yang
authors.initials: XY
authors.lastname: Chu
authors.forename: Yu-e
authors.initials: YE
authors.lastname: Sun
authors.forename: Zhan-bo
authors.initials: ZB
authors.lastname: Wang
authors.forename: Xiang-hong
authors.initials: XH
authors.lastname: Li
authors.forename: Gao-kui
authors.initials: GK
authors.lastname: Zhang
mesh_terms: D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis / Q000378:metabolism / Q000556:secondary*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053539:Keratin-19 / Q000032:analysis; D008175:Lung Neoplasms / Q000378:metabolism / Q000473:pathology*; D008198:Lymph Nodes / Q000737:chemistry / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging
chemical_list: D053539:Keratin-19