Abstract | BACKGROUND: It is not clear if sentinel lymph node (SLN) mapping can improve outcomes in patients with colorectal cancers. The purpose of this study was to determine the prognostic values of ex vivo sentinel lymph node (SLN) mapping and immunohistochemical (IHC) detection of SLN micrometastasis in colorectal cancers. METHODS: RESULTS: A total of 54 patients between 25 and 82 years of age were enrolled, including 32 males and 22 females. More than 70% of patients were T3 or above, about 86% of patients were stage II or III, and approximately 90% of patients had lesions grade II or above. Sentinel lymph nodes were detected in all 54 patients. There were 32 patients in whom no lymph node micrometastasis were detected by HE staining and 22 patients with positive lymph nodes micrometastasis detected by HE staining in non-SLNs. In contrast only 7 SLNs stained positive with HE. Using HE examination as the standard, the sensitivity, non-detection rate, and accuracy rate of SLN micrometastasis detection were 31.8% (7/22), 68.2% (15/22), and 72.2%, respectively. Micrometastasis were identified by ICH in 4 of the 32 patients with HE-negative stained lymph nodes, resulting in an upstaging rate 12.5% (4/32). The 4 patients who were upstaged consisted of 2 stage I patients and 2 stage II patients who were upstaged to stage III. Those without lymph node metastasis by HE staining who were upstaged by IHC detection of micrometastasis had a significantly poorer disease-free survival (p = 0.001) and overall survival (p = 0.004). CONCLUSION:
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Authors | Fu-Long Wang, Fang Shen, De-Sen Wan, Zhen-Hai Lu, Li-Ren Li, Gong Chen, Xiao-Jun Wu, Pei-Rong Ding, Ling-Heng Kong, Zhi-Zhong Pan |
Journal | Diagnostic pathology
(Diagn Pathol)
Vol. 7
Pg. 71
(Jun 22 2012)
ISSN: 1746-1596 [Electronic] England |
PMID | 22726450
(Publication Type: Journal Article)
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Chemical References |
- Biomarkers, Tumor
- Keratins
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Topics |
- Adult
- Aged
- Aged, 80 and over
- Biomarkers, Tumor
(analysis)
- Colorectal Neoplasms
(chemistry, mortality, pathology, surgery)
- Disease-Free Survival
- Feasibility Studies
- Female
- Humans
- Immunohistochemistry
- Kaplan-Meier Estimate
- Keratins
(analysis)
- Lymph Nodes
(chemistry, pathology, surgery)
- Lymphatic Metastasis
- Male
- Middle Aged
- Multivariate Analysis
- Neoplasm Micrometastasis
- Neoplasm Staging
- Predictive Value of Tests
- Prognosis
- Proportional Hazards Models
- Risk Assessment
- Risk Factors
- Sensitivity and Specificity
- Sentinel Lymph Node Biopsy
- Time Factors
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