title: Is minimal residual lymph node disease in papillary thyroid cancer of prognostic impact? An analysis of the epithelial cell adhesion molecule EpCAM in lymph nodes of 40 pN0 patients.
abstract: This study was aimed to assess the extend of nodal microdissemination in patients with pN0 papillary thyroid carcinoma (PTC) using immunohistochemical analysis. In early stage PTC both, systematic lymphadenectomy as well as radio iodine treatment, aimed to eliminate occult nodal tumor involvement, are under controversial debate, since little is known about the extend of lymphatic microdissemination in these patients. Formalin embedded samples of the resected lymph nodes were systematically screened for the presence of disseminated tumor cells using immunohistochemistry (monoclonal antibody Ber-EP4). Clinical and histopathological parameters as well as the post-operative course were recorded. Survival data were analysed by the Kaplan-Meier method and the log rank test. Overall 321 lymph nodes of 40 patients were screened immunohistochemically. In 12.5% of the patients disseminated occult tumor cells were diagnosed. In addition to tumor resection 90% of the patients underwent adjuvant radio-iodine treatment. The mean observation period in our collective was 72 months. The detection of disseminated tumor cells did not correlate with clinicopathologic risk parameters and did not have significant influence on the prognosis of these patients. Immunohistochemical analysis enables the detection of disseminated tumor cells in patients with pN0 PTC. This finding seems to support the application of adjuvant radio iodine, even in early tumor stages.
authors.affiliation: Department of Surgery, Heinrich Heine University, Düsseldorf, Germany, rehders@med.uni-duesseldorf.de.
authors.forename: Alexander
authors.initials: A
authors.lastname: Rehders
authors.forename: Martin
authors.initials: M
authors.lastname: Anlauf
authors.forename: Ilona
authors.initials: I
authors.lastname: Adamowsky
authors.forename: Markus H
authors.initials: MH
authors.lastname: Ghadimi
authors.forename: Sarah
authors.initials: S
authors.lastname: Klein
authors.forename: Christina
authors.initials: C
authors.lastname: Antke
authors.forename: Kenko
authors.initials: K
authors.lastname: Cupisti
authors.forename: Nikolas H
authors.initials: NH
authors.lastname: Stoecklein
authors.forename: Wolfram T
authors.initials: WT
authors.lastname: Knoefel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000951:Antigens, Neoplasm / Q000378:metabolism*; D002277:Carcinoma / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D002291:Carcinoma, Papillary; D015815:Cell Adhesion Molecules / Q000378:metabolism*; D002648:Child; D000071858:Epithelial Cell Adhesion Molecule; D004847:Epithelial Cells / Q000378:metabolism / Q000473:pathology; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008197:Lymph Node Excision / Q000379:methods; D008198:Lymph Nodes / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D018365:Neoplasm, Residual / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D011379:Prognosis; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D055815:Young Adult
chemical_list: D000951:Antigens, Neoplasm; D015815:Cell Adhesion Molecules; C499379:EPCAM protein, human; D000071858:Epithelial Cell Adhesion Molecule
references.citation: BMC Cancer. 2006 Jun 23;6:165
references.pmid: 16796747
references.citation: Cancer. 1999 Dec 15;86(12):2668-73
references.pmid: 10594862
references.citation: Ann Surg Oncol. 2008 May;15(5):1518-22
references.pmid: 18324441
references.citation: Eur J Endocrinol. 2008 Apr;158(4):551-60
references.pmid: 18362303
references.citation: World J Surg. 2007 Nov;31(11):2085-91
references.pmid: 17885787
references.citation: Int J Colorectal Dis. 2004 Sep;19(5):430-7
references.pmid: 14716495
references.citation: Thyroid. 2006 Feb;16(2):109-42
references.pmid: 16420177
references.citation: World J Surg. 2004 Nov;28(11):1103-9
references.pmid: 15490070
references.citation: Surgery. 2009 Dec;146(6):1182-7
references.pmid: 19958947
references.citation: Cancer. 1979 Mar;43(3):810-20
references.pmid: 427722
references.citation: J Surg Oncol. 2007 Jun 1;95(7):555-60
references.pmid: 17226813
references.citation: Cancer. 2006 Feb 1;106(3):524-31
references.pmid: 16369995
references.citation: World J Surg. 2007 Mar;31(3):483-90; discussion 491-2
references.pmid: 17219277
references.citation: HPB (Oxford). 2007;9(2):135-9
references.pmid: 18333129
references.citation: World J Surg. 2004 Nov;28(11):1088-92
references.pmid: 15490055
references.citation: Head Neck. 1996 Mar-Apr;18(2):127-32
references.pmid: 8647677
references.citation: Surgery. 2002 Mar;131(3):249-56
references.pmid: 11894028
references.citation: Surg Oncol. 2008 Sep;17(3):253-8
references.pmid: 18504121
references.citation: Nucl Med Commun. 2000 Jun;21(6):529-32
references.pmid: 10894561
references.citation: World J Surg. 2006 Jan;30(1):91-9
references.pmid: 16369721
references.citation: J Clin Endocrinol Metab. 1990 Aug;71(2):414-24
references.pmid: 2380337
references.citation: J Histochem Cytochem. 1981 Nov;29(11):1349-53
references.pmid: 6172466
references.citation: J Clin Pathol. 1990 Mar;43(3):213-9
references.pmid: 1692040
references.citation: J Clin Oncol. 2003 Jul 1;21(13):2609-15
references.pmid: 12829682
references.citation: Arch Otolaryngol Head Neck Surg. 2009 Nov;135(11):1092-7
references.pmid: 19917920
references.citation: N Engl J Med. 1997 Oct 23;337(17):1188-94
references.pmid: 9337377
references.citation: World J Surg. 2007 Apr;31(4):838-48
references.pmid: 17347900
references.citation: Clin Endocrinol (Oxf). 2005 Feb;62(2):156-62
references.pmid: 15670190
references.citation: Endocrinol Metab Clin North Am. 2008 Jun;37(2):457-80, x
references.pmid: 18502337
references.citation: Thyroid. 2009 Jul;19(7):683-9
references.pmid: 19583485
references.citation: Arch Surg. 1998 Mar;133(3):276-80
references.pmid: 9517740
references.citation: Ann Surg. 2003 Mar;237(3):399-407
references.pmid: 12616125