title: Occult neoplastic cells in the lymph node sinuses and recurrence/metastasis of stage III/Dukes' C colorectal cancer.
abstract: Lymph nodes from patients with colorectal cancer were immunohistochemically stained for cytokeratin to investigate the relationship between the presence of occult neoplastic cells (ONCs) and recurrence/metastasis. A total of 80 patients with stage III/Dukes' C colorectal cancer were divided into 16 patients who developed recurrence/metastasis (recurrence group) and 64 patients without recurrence (non-recurrence group). ONCs were compared between the two groups with respect to i) single cells (≥ 3 floating ONCs), ii) clusters of cells (1 or more floating aggregates of 2-20 ONCs) and iii) single cells + clusters. When single cells were detected, the sensitivity for recurrence was 87.5% (14/16, p = 0.002), the positive predictive value (PPV) was 32.6% (14/43), the specificity was 54.7% (35/64) and the negative predictive value (NPV) was 94.6% (35/37). For clusters, the sensitivity was 87.5% (14/16, p<0.001), PPV was 41.2% (14/34), specificity was 68.8% (44/64) and NPV 95.7% (44/46). With single cells + clusters, the values were 87.5% (14/16, p<0.001), 48.3% (14/29), 76.6% (49/64) and 96.1% (49/51), respectively. These results suggest that the detection of single cells + clusters is a sensitive indicator of a high risk of recurrence/ metastasis, while ONCs are useful for identifying the low-risk group of patients with stage III colorectal cancer.
authors.affiliation: Department of Pathology, Tokai University Hachioji Hospital, Ishikawa-cho 1838, Hachioji, Tokyo 192-0032, Japan. sekido.yasutomo@hachioji-hosp.tokai.ac.jp
authors.forename: Yasutomo
authors.initials: Y
authors.lastname: Sekido
authors.forename: Masaya
authors.initials: M
authors.lastname: Mukai
authors.forename: Kyoko
authors.initials: K
authors.lastname: Kishima
authors.forename: Takayuki
authors.initials: T
authors.lastname: Tajima
authors.forename: Tatsuhiko
authors.initials: T
authors.lastname: Hoshikawa
authors.forename: Masato
authors.initials: M
authors.lastname: Nakamura
authors.forename: Naoya
authors.initials: N
authors.lastname: Nakamura
authors.forename: Kyoji
authors.initials: K
authors.lastname: Ogoshi
mesh_terms: D015179:Colorectal Neoplasms / Q000378:metabolism / Q000473:pathology*; D006801:Humans; D007124:Immunoenzyme Techniques; D007633:Keratins / Q000378:metabolism; D008198:Lymph Nodes / Q000378:metabolism / Q000473:pathology*; D008207:Lymphatic Metastasis; D009364:Neoplasm Recurrence, Local / Q000378:metabolism / Q000473:pathology*; D009367:Neoplasm Staging; D011379:Prognosis; D012680:Sensitivity and Specificity
chemical_list: D007633:Keratins