Annals of Surgical Oncology

, Volume 11, Supplement 3, pp 250S–254S

Significance of metastasis detected by molecular techniques in sentinel nodes of patients with gastrointestinal cancer

  • Jun-ichi Matsuda
  • Yuko Kitagawa
  • Hirofumi Fujii
  • Makio Mukai
  • Katsuaki Dan
  • Tetsuro Kubota
  • Masahiko Watanabe
  • Soji Ozawa
  • Yoshihide Otani
  • Hirotoshi Hasegawa
  • Yoshimasa Shimizu
  • Koichiro Kumai
  • Atsushi Kubo
  • Masaki Kitajima
Article
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Abstract

The clinical significance of micrometastasis in sentinel nodes (SNs) may differ in various organs. In particular, the prognostic value of SN micrometastases detected by reverse transcriptase-polymerase chain reaction (RT-PCR) is still controversial. We investigated the diagnostic and therapeutic significance of nodal molecular metastasis detected, by nested RT-PCR for cytokeratin (CK) 19 mRNA in gastrointestinal cancer. In 51 cases with GI tract cancer treated by standard curative resection, SNs were identified by a radio-guided method. In 10 of 51 patients, 25 SNs and 3 non-SNs were histologically negative and RT-PCR positive. Three non-SNs with positive CK19 mRNA were randomly sampled from the same basin where histologically positive SNs were identified. Immunohistochemical analysis of six additional step sections obtained at 30-μm intervals with use of an anticytokeratin antibody showed clearly recognizable histological metastases in 4 of 25 histologically negative/RT-PCR-positive SNs (16%). In one case of esophageal squamous cell carcinoma with nodal micrometastasis identified by CK19 RT-PCR, extranodal local recurrence in the SN basin (left supraclavicular basin) was observed 6 months postoperatively. These findings suggest that nodal micrometastasis detected by nested RT-PCR has some clinical significance in GI cancer. Molecular assessment of the SN may be a valuable tool to complement routine histological examination for GI cancers.

Key Words

Colorectal cancer Esophageal cancer Gastric cancer Sentinel node Micrometastasis RT-PCR 

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Copyright information

© The Society of Surgical Oncology, Inc. 2004

Authors and Affiliations

  • Jun-ichi Matsuda
    • 1
  • Yuko Kitagawa
    • 1
  • Hirofumi Fujii
    • 2
  • Makio Mukai
    • 3
  • Katsuaki Dan
    • 4
  • Tetsuro Kubota
    • 1
  • Masahiko Watanabe
    • 1
  • Soji Ozawa
    • 1
  • Yoshihide Otani
    • 1
  • Hirotoshi Hasegawa
    • 1
  • Yoshimasa Shimizu
    • 1
  • Koichiro Kumai
    • 1
  • Atsushi Kubo
    • 2
  • Masaki Kitajima
    • 1
  1. 1.Department of SurgeryKeio UniversityTokyoJapan
  2. 2.Department of RadiologyKeio UniversityTokyoJapan
  3. 3.Department of PathologyKeio UniversityTokyoJapan
  4. 4.School of MedicineKeio UniversityTokyoJapan

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