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.
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Bilchik AJ, Saha S, Wiese D, et al. Molecular staging of early colon cancer on the basic of sentinel node analysis: a multicenter phase II trial.J Clin Oncol 2001;19:1128–36.
Saha S, Nora D, Wong JH, et al. Sentinel node mapping in colorectal cancer: a review.Surg Clin N Am 2000;80:1811–9.
Kitagawa Y, Fujii H, Mukai M, et al. Radio-guided sentinel node detection for gastric cancer: a review.Br J Surg 2002;89:604–8.
Hiratsuka M, Miyashiro I, Ishikawa O, et al. Application of sentinel node biopsy to gastric cancer surgery.Surgery 2001;129:335–40.
Kitagawa Y, Watanabe M, Hasegawa H, et al. Sentinel node mapping for colorectal cancer with radioactive tracer.Dis Colon Rectum 2002;45:1476–80.
Gibbs JF, Huang PP, Zhang PJ, et al. Accuracy of pathologic techniques for the diagnosis of metastatic melanoma in sentinel lymph nodes.Ann Surg Oncol 1999;6:699–704.
Turner RR, Giuliano AE. Intraoperative pathologic examination of the sentinel lymph node.Ann Surg Oncol 1998;5:991–3.
Zurrida S, Galimberti V, Orvieto E, et al. Radioguided sentinel node biopsy to avoid axillary dissection in breast cancer,Ann Surg Oncol 2000;7:28–31.
Kitagawa Y, Fujii H, Mukai M, et al. The role of sentinel lymph nodes in gastrointestinal cancer.Surg Clin N Am 2000;80:1799–809.
Ando N, Iizuka T, Ide H, et al. A randomized trial of surgery alone vs surgery plus postoperative chemotherapy with cisplatin and 5-fluorouracil for localized squamous carcinoma of thoracic esophagus: The Japan Clinical Oncology Group Study (JCOG9204).Proc Am Soc Clin Oncol 1999:1034.
Kitagawa Y, Ohgami M, Fujii H, et al. Laparoscopic detection of sentinel lymph nodes in gastrointestinal cancer: a novel and minimally invasive approach.Ann Surg Oncol 2001;8:86–9.
Miwa K, Kinami S, Taniguchi K, et al. Mapping sentinel nodes in patients with early-stage gastric carcinoma.Br J Surg 2003;90: 178–82.
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Matsuda, Ji., Kitagawa, Y., Fujii, H. et al. Significance of metastasis detected by molecular techniques in sentinel nodes of patients with gastrointestinal cancer. Annals of Surgical Oncology 11 (Suppl 3), 250S–254S (2004). https://doi.org/10.1007/BF02523639
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DOI: https://doi.org/10.1007/BF02523639