The prognostic significance of isolated tumor cells in the lymph nodes of gastric cancer patients

Early detection of disseminated tumor cells in the peripheral blood of patients with early stage gastric cancer could help to improve the outcome after tumor resection. The aim of this study is to evaluate the prognostic significance of tumor-related mRNA for the detection of circulating tumor cells in gastric cancer patients by a reverse-transcriptase polymerase chain reaction (RT-PCR) method. We simultaneously analyzed human telomerase reverse transcriptase (hTERT), cytokeratin-19 (CK-19), cytokeratin-20 (CK-20) and carcinoembryonic antigen (CEA) mRNA (messenger RNA) expression in the peripheral blood of 42 gastric cancer patients and 30 healthy individuals. Additionally, analyses were carried out for the correlation of these four molecular markers with patients’ clinicopathologic features, as well as the occurrence of postoperative recurrence/metastasis. Among 42 gastric cancer patients, the prevalence of mRNA for hTERT, CK-19, CK-20, and CEA was 61.9% (26/42), 69% (29/42), 61.9% (26/42), and 78.6% (33/42), respectively. All 30 healthy individuals were negative for hTERT and CEA mRNA, while two were positive for either CK-19 mRNA or CK-20 mRNA. Positive CEA mRNA was significantly correlated with tumor size (p= 0.008), vessel invasion (p= 0.001), depth of tumor invasion (p= 0.007), lymph node metastasis (p< 0.001), and TNM stage (p< 0.001). In addition, the multivariate logistic regression demonstrated that CEA mRNA expression was an independent and significant predictor for postoperative recurrence/metastasis (p= 0.032). Our findings suggest that CEA mRNA may be a more reliable marker than hTERT, CK-19 and CK-20 for the detection of circulating cancer cells in gastric cancer patients' peripheral blood. Patients with positive CEA mRNA expression in peripheral blood have a significantly higher risk of postoperative recurrence/metastasis.

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The Prognostic Significance of Isolated Tumor Cells Detected Within Lateral Lymph Nodes in Rectal Cancer Patients After Laparoscopic Lateral Lymph Node Dissection

Journal of Laparoendoscopic & Advanced Surgical Techniques ◽

10.1089/lap.2019.0489 ◽

2019 ◽

Vol 29 (11) ◽

pp. 1462-1468

Author(s):

Xuyang Yang ◽

Tao Hu ◽

Chaoyang Gu ◽

Shuo Yang ◽

Dan Jiang ◽

...

Keyword(s):

Rectal Cancer ◽

Lymph Node ◽

Lymph Nodes ◽

Cancer Patients ◽

Tumor Cells ◽

Lymph Node Dissection ◽

Prognostic Significance ◽

Node Dissection ◽

Isolated Tumor Cells ◽

Lateral Lymph Node

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DETECTION OF OCCULT LYMPH NODE TUMOR CELLS IN NODE-NEGATIVE GASTRIC CANCER PATIENTS

ABCD Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) ◽

10.1590/0102-6720201700010009 ◽

2017 ◽

Vol 30 (1) ◽

pp. 30-34 ◽

Cited By ~ 8

Author(s):

Marina Alessandra PEREIRA ◽

Marcus Fernando Kodama Pertille RAMOS ◽

Andre Roncon DIAS ◽

Osmar Kenji YAGI ◽

Sheila Friedrich FARAJ ◽

...

Keyword(s):

Gastric Cancer ◽

Lymph Node ◽

Lymph Nodes ◽

Cancer Patients ◽

Tumor Cells ◽

Node Negative ◽

Occult Tumor ◽

Increased Risk ◽

Gastric Cancer Patients ◽

Occult Tumor Cells

ABSTRACT Background: The presence of lymph nodes metastasis is one of the most important prognostic indicators in gastric cancer. The micrometastases have been studied as prognostic factor in gastric cancer, which are related to decrease overall survival and increased risk of recurrence. However, their identification is limited by conventional methodology, since they can be overlooked after routine staining. Aim: To investigate the presence of occult tumor cells using cytokeratin (CK) AE1/AE3 immunostaining in gastric cancer patients histologically lymph node negative (pN0) by H&E. Methods: Forty patients (T1-T4N0) submitted to a potentially curative gastrectomy with D2 lymphadenectomy were evaluated. The results for metastases, micrometastases and isolated tumor cells were also associated to clinicopathological characteristics and their impact on stage grouping. Tumor deposits within lymph nodes were defined according to the tumor-node-metastases guidelines (7th TNM). Results: A total of 1439 lymph nodes were obtained (~36 per patient). Tumor cells were detected by immunohistochemistry in 24 lymph nodes from 12 patients (30%). Neoplasic cells were detected as a single or cluster tumor cells. Tumor (p=0.002), venous (p=0.016), lymphatic (p=0.006) and perineural invasions (p=0.04), as well as peritumoral lymphocytic response (p=0.012) were correlated to CK-positive immunostaining tumor cells in originally negative lymph nodes by H&E. The histologic stage of two patients was upstaged from stage IB to stage IIA. Four of the 28 CK-negative patients (14.3%) and three among 12 CK-positive patients (25%) had disease recurrence (p=0.65). Conclusion: The CK-immunostaining is an effective method for detecting occult tumor cells in lymph nodes and may be recommended to precisely determine tumor stage. It may be useful as supplement to H&E routine to provide better pathological staging.

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