title: Detection of sentinel and non-sentinel lymph node micrometastases by complete serial sectioning and immunohistochemical analysis for gastric cancer.
abstract: BACKGROUND
  We investigated the presence and distribution of the sentinel and the non-sentinel node micrometastases using complete serial sectioning and immunohistochemical staining (IHC), to inspect whether lymph node micrometastases spread to the sentinel lymph nodes first.
  
  
  METHODS
  A total of 35 patients, who underwent gastrectomy with a sentinel lymph node biopsy for gastric cancer, were enrolled in this study. Total of 1028 lymph nodes of 35 patients having gastric cancer without metastasis of lymph node by permanent section with hematoxylin and eosin staining (H&E) were selected. There were 252 sentinel nodes and the other 776 were non-sentinel nodes. All nodes were sectioned serially and stained alternately with H&E and IHC. Lymph node micrometastases was defined as proving to be positive first either the IHC or the complete serial sectioning.
  
  
  RESULTS
  Micrometastases were detected in 4 (11%) of the 35 patients, 6 (0.58%) of 1028 nodes. Of these 4 patients, 3 had micrometastases exclusively in sentinel nodes, and the other had micrometastasis in both sentinel and non-sentinel nodes. There was no patient who had the micrometastases only in non-sentinel nodes.
  
  
  CONCLUSIONS
  These results support the concept that lymph node micrometastasis of gastric cancer spreads first to sentinel nodes.
authors.affiliation: Department of Gastroenterologic Surgery, Kanazawa University Hospital, 13-1 Takara-machi, Kanazawa 920-8641, Ishikawa, Japan. k.ishii@med.kurobe.toyama.jp
authors.forename: Kaname
authors.initials: K
authors.lastname: Ishii
authors.forename: Shinichi
authors.initials: S
authors.lastname: Kinami
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Funaki
authors.forename: Hideto
authors.initials: H
authors.lastname: Fujita
authors.forename: Itasu
authors.initials: I
authors.lastname: Ninomiya
authors.forename: Sachio
authors.initials: S
authors.lastname: Fushida
authors.forename: Takashi
authors.initials: T
authors.lastname: Fujimura
authors.forename: Genichi
authors.initials: G
authors.lastname: Nishimura
authors.forename: Masato
authors.initials: M
authors.lastname: Kayahara
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy; D013274:Stomach Neoplasms / Q000473:pathology*