title: Detection and clinical significance of lymph node micrometastasis in gastric cardia adenocarcinoma.
abstract: OBJECTIVE
  Lymph node micro metastasis was investigated in gastric cardia adenocarcinoma (GCA) patients without lymph node metastasis on routine pathological examination. The relationship between micrometastasis and clinicopathological features was also evaluated.
  
  
  METHODS
  A total  of 349 lymph nodes were obtained from 45 patients with GCA. Micrometastases were detected by immunohistochemical staining for the markers cytokeratin 19 (CK19) and CD44 variant 6 (CD44v6).
  
  
  RESULTS
  A total of 33 lymph nodes (9.5%) from 15 patients (33.3%) were positive for CK19. Of these,  27 lymph nodes (7.7%) from 12 patients (26.7%) were also positive for CD44v6. Micrometastasis was significantly related to depth of tumour invasion and Lauren classification (intestinal or diffuse). The recurrence rate was significantly higher and 2-year survival rate significantly lower in  patients with than in those without lymph node micrometastasis, showing the necessity of detecting micrometastasis in GCA patients who test negative for lymph node metastasis on routine examination.
  
  
  CONCLUSIONS
  CK19 and CD44v6 were shown to be good markers for micrometastasis detection.
authors.affiliation: Department of Oncology, Cancer Institute, First Affiliated Hospital of Henan University of Science and Technology, Luoyang, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Ru
authors.forename: L
authors.initials: L
authors.lastname: Zhang
authors.forename: Q
authors.initials: Q
authors.lastname: Chen
authors.forename: S G
authors.initials: SG
authors.lastname: Gao
authors.forename: G P
authors.initials: GP
authors.lastname: Wang
authors.forename: Z F
authors.initials: ZF
authors.lastname: Qu
authors.forename: T Y
authors.initials: TY
authors.lastname: Shan
authors.forename: N
authors.initials: N
authors.lastname: Qian
authors.forename: X S
authors.initials: XS
authors.lastname: Feng
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000473:pathology; D000328:Adult; D000368:Aged; D002299:Cardia / Q000473:pathology*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis / Q000175:diagnosis* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D061206:Neoplasm Micrometastasis / Q000175:diagnosis* / Q000473:pathology; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000473:pathology*