BACKGROUND AND OBJECTIVES: Lymph node metastasis is known as a significant predictor of prognosis in colorectal cancer patients. Recently, reverse transcriptase polymerase chain reaction (RT-PCR) has been applied to detecting micrometastasis. To assess the risk of recurrence and accurately determine the spread of tumor cells, we examined lymph node micrometastases in a series of colorectal cancer patients. METHODS: We examined 202 lymph nodes obtained from 13 colorectal cancer patients who underwent curative operation and were histologically diagnosed to be node-negative, using RT-PCR to amplify mRNAs for two epithelial markers, carcinoembryonic antigen (CEA) and cytokeratin 20 (CK-20). RESULTS: All the cases, including early stage patients, had micrometastases. A total of 102 among 202 lymph nodes (50.5%) were positive for either CEA or CK-20, or both (47.0, 40.1, and 36.6% respectively). Positive lymph nodes were spread along the courses of vascular trunks as well as being located in more distant regions. CONCLUSIONS: Even in histologically negative lymph nodes, there is a considerable possibility that micrometastases may exist. Their detection by RT-PCR may improve clinical staging and indications for cancer therapy. We should also take care in the choice of surgical approach.
BACKGROUND AND OBJECTIVES: Lymph node metastasis is known as a significant predictor of prognosis in colorectal cancerpatients. Recently, reverse transcriptase polymerase chain reaction (RT-PCR) has been applied to detecting micrometastasis. To assess the risk of recurrence and accurately determine the spread of tumor cells, we examined lymph node micrometastases in a series of colorectal cancerpatients. METHODS: We examined 202 lymph nodes obtained from 13 colorectal cancerpatients who underwent curative operation and were histologically diagnosed to be node-negative, using RT-PCR to amplify mRNAs for two epithelial markers, carcinoembryonic antigen (CEA) and cytokeratin 20 (CK-20). RESULTS: All the cases, including early stage patients, had micrometastases. A total of 102 among 202 lymph nodes (50.5%) were positive for either CEA or CK-20, or both (47.0, 40.1, and 36.6% respectively). Positive lymph nodes were spread along the courses of vascular trunks as well as being located in more distant regions. CONCLUSIONS: Even in histologically negative lymph nodes, there is a considerable possibility that micrometastases may exist. Their detection by RT-PCR may improve clinical staging and indications for cancer therapy. We should also take care in the choice of surgical approach.
Authors: Ulrich Guller; Paul Zajac; Annelies Schnider; Beatrix Bösch; Stefan Vorburger; Markus Zuber; Giulio Cesare Spagnoli; Daniel Oertli; Robert Maurer; Urs Metzger; Felix Harder; Michael Heberer; Walter Richard Marti Journal: Ann Surg Date: 2002-12 Impact factor: 12.969
Authors: S Lassmann; M Bauer; R Rosenberg; H Nekarda; R Soong; R Rüger; H Höfler; M Werner Journal: Int J Colorectal Dis Date: 2003-09-10 Impact factor: 2.571
Authors: J Harder; V Engelstaedter; H Usadel; S Lassmann; M Werner; P Baier; F Otto; M Varbanova; E Schaeffner; M Olschewski; H E Blum; O G Opitz Journal: Br J Cancer Date: 2009-01-13 Impact factor: 7.640