title: The clinical importance of micrometastases within the lymphatic system in patients after total gastrectomy.
abstract: BACKGROUND
  In spite of radical gastrectomy with resection of the lymphatic system, where no metastases are found during histopathological examination, about 30% of patients have relapse of the neoplastic process. This situation may be caused by micrometastases or isolated neoplastic cells in the lymphatic system which were not identified during a standard histopathological examination.
  
  
  OBJECTIVE
  The aim of the study was to evaluate the clinical importance of micrometastases within the lymphatic system in patients with gastric cancer.
  
  
  METHODS
  A group of 20 patients treated for gastric cancer were subjected to retrospective analysis. Of all the patients who underwent surgery, a group with tumours classified as T1 or T2 was selected. No metastases within the lymphatic system were found in the standard evaluation - N0 mark. Paraffin-embedded blocks of lymph nodes were cut and new specimens were made, which were then stained again by means of immunohistochemistry. Antibodies against cytokeratin AE1/AE3 were used.
  
  
  RESULTS
  A total of 319 lymph nodes were assessed in 20 patients in an H + E examination. After the immunohistochemical examination, micrometastases within the lymphatic system were found in 4 (20%) patients and isolated neoplastic cells in other 4 (20%) patients.
  
  
  CONCLUSIONS
  On the basis of numerous publications and our own material, we think that the presence of micrometastases may be related to a worse prognosis. The clinical importance of micrometastases within the lymphatic system in patients after total gastrectomy.
authors.affiliation: I Ward of Surgical Oncology, Greatpoland Cancer Center, Poznań, Poland.
authors.forename: Arkadiusz
authors.initials: A
authors.lastname: Spychała
authors.affiliation: I Ward of Surgical Oncology, Greatpoland Cancer Center, Poznań, Poland.
authors.forename: Dawid
authors.initials: D
authors.lastname: Murawa
authors.affiliation: Department of Pathology, Greatpoland Cancer Center, Poznań, Poland.
authors.forename: Konstanty
authors.initials: K
authors.lastname: Korski
keywords: Gastric cancer; Isolated tumour cells; Micrometastases