[Mediastinal lymph nodes micro-metastases in patients with clinical stage I-II lung cancer].

Abstract

OBJECTIVE:

To investigate micro-metastasis in mediastinal lymph nodes (mLN) of patients with clinical stage I approximately II lung cancer and its clinical significance.

METHODS:

A total of 181 mLN from 32 lung cancer patients in clinical stage I approximately II were collected during operation and their frozen sections at two different levels were examined immunohistochemically (IHC) with an anti-epithelial cell monoclonal antibody Ber-Ep4. Routine HE staining was done for comparison. The results were processed by Chi-square tests in SPSS 10.0 soft ware.

RESULTS:

Fifteen of the 32 patients (46.9%) were found to have micro-metastasis in 21 of 181 mLN (11.6%) examined by immunohistochemical staining though routine histopathological examinations were negative. Of those 15 cases, micro-metastasis was detected in 9 only by IHC and in 6 both by IHC and HE stainings. The positive rate of micro-metastasis in N0, N1, and N2 stratified by routine pathology was 36.8% (7/19), 33.3% (2/6) and 85.7% (6/7), respectively (N0 vs N2, P < 0.05). When stratified according to clinical staging (cTNM), pathological staging (pTNM) and pathological staging on the basis of IHC (iTNM), the frequencies of N2 cases were 0, 18.8% and 46.9%, respectively (differences among the three groups: P < 0.01). Nine cases reported as N0(7) and N1(2) by routine histopathological examination were found to have micro-metastasis in mLN by IHC staining, therefore they were actually N2 cases.

CONCLUSION:

IHC staining with a monoclonal antibody specific for epithelial cells (Ber-Ep4) is more sensitive in the detection of mediastinal micro-metastais than routine HE staining. Underestimation of the extent of mLN metastasis by cTNM and/or pTNM stagings frequently exists in patients with clinically early lung cancer.

• Authors: You-sheng Mao, De-chao Zhang, Hong-tu Zhang, Yun-tian Sun, Xiao-hang Zhao, Xiu-ying Liu, Guo-lian Wei, Fang Liu
• Journal: Zhonghua zhong liu za zhi [Chinese journal of oncology] (Zhonghua Zhong Liu Za Zhi) Vol. 27 Issue 3 Pg. 160-3 (Mar 2005) ISSN: 0253-3766 [Print] China
• PMID: 15946566 (Publication Type: English Abstract, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antibodies, Monoclonal
• Ber-EP4 monoclonal antibody

Topics

• Adenocarcinoma (pathology, secondary)
• Adult
• Aged
• Antibodies, Monoclonal
• Carcinoma, Squamous Cell (pathology, secondary)
• Female
• Humans
• Lung Neoplasms (pathology)
• Lymph Nodes (pathology)
• Lymphatic Metastasis
• Male
• Mediastinum
• Middle Aged
• Neoplasm Staging