淋巴结微转移检测对大肠癌病理分期的影响

目的 研究淋巴结微转移对结肠癌患者病理分期的影响.方法 对1120枚结直肠癌患者淋巴结进行常规HE染色和CK20、CEA免疫组化微转移的检测,并对结果进行统计学分析.结果 CK20检测出有微转移淋巴结103枚,占9.2％(103/1120),CEA检测出有微转移淋巴结88枚,占7.9％ (88/1120).CK20联合CEA检测出130枚淋巴结检出有微转移,占11.6％ (130/1120).肿瘤浸润愈深,微转移愈易发生(P＜0.05),分化程度低者,微转移阳性率高(P＜0.05).130枚淋巴结检出有微转移,13例TNM分期提高,其中Ⅰ期→Ⅲ期2例,Ⅱ期→Ⅲ期11例,HE染色重新分期率为18.6％ (13/70).结论 结直肠癌淋巴结免疫组化检测有助于更准确地进行结直肠癌的临床病理分期.     

食管癌血液及淋巴结微转移检测及其对预后的影响

采用RT-PCR技术检测52例食管癌患者术前外周血液及术后病理诊断阴性的212枚区域淋巴结(pN0)中癌胚抗原(CEA)mRNA的表达.发现15例患者的术前血液中检测到CEA mRNA表达.17例患者的24枚淋巴结检测到CEA mRNA表达.CEA mRNA表达与肿瘤分化程度及浸润深度显著相关(P＜0.05).血液及淋巴结微转移者3 a生存率均明显低于无微转移者(P均＜0.05).多因素回归分析结果显示,肿瘤浸润深度、血液微转移及淋巴结微转移是独立的预后因素(P均＜0.05).认为微转移与食管癌术后早期复发转移及预后不良有关,检测食管癌术前血液及术后病理诊断阴性的pN0中CEA mRNA表达,可以诊断食管癌微转移.     

结直肠癌淋巴结的分期

目的:分析结直肠癌淋巴结转移状况与预后的关系,提出新的结直肠癌淋巴结分期方案.方法:122例病理资料完整的结直肠癌病例,比较不同删分期(AJCC/UICC)病例的5年生存率:将淋巴结转移数目≥10枚和顶端淋巴结转移拟定为N,期,比较AJCC/UICC的TNM分期中No、N1、N2与N3期病例的5年生存率;按Kaplan-Meier方法计算生存率,绘制生存曲线,并对生存率进行Log-rank检验.结果:随着TNM分期的上升,5年生存率逐渐下降(Ⅰ期为100%;Ⅱ期为81.82%;ⅢAB期为69-39%,ⅢC期为15%:Ⅳ期为0,P<0.01),随着N分期的上升,5年生存率也逐渐下降(N0Ⅰ期为100%、N0Ⅱ期为89.82%、N1期69.39%,N2期为15%,P<0.01).N3期病例5年生存率为0,与TNM的Ⅳ期预后相似.结论:建议将结直肠癌TNM中的N分期定为:无淋巴结转移为N0,1-3枚淋巴结转移为N1,4-9枚淋巴结转移为N2,≥10枚淋巴结转移和/或顶端淋巴结转移为N3.N3期患者的5年生存率为0,与M1期结果相似,可以定为亚临床转移.     

淋巴结转移阴性结直肠癌患者的预后因素分析

目的探讨淋巴结转移阴性结直肠癌患者临床病理特点与预后的相关性,为临床治疗提供依据。方法选择116例同期行结肠癌根治术、术后检取12个以上淋巴结均无转移患者为研究对象,随访观察1、3、5 a生存率,并对可能影响预后的临床病理指标采用Kaplan-Meier法行单因素分析、采用Cox比例风险模型行多因素分析。结果单因素分析表明肿瘤大小、浸润深度和组织分化程度与预后有显著相关性（P〈0.05）;多因素分析表明术前癌胚抗原（CEA）水平、肿瘤大小和浸润深度为结直肠癌的独立预后因素（P〈0.05）。结论术前CEA水平和浸润深度可影响淋巴结转移阴性结直肠癌患者的预后,据此制定规范化个体治疗方案有望提高患者的生存率。     

外周血肿瘤细胞CK20表达与结直肠癌患者术后复发和转移的关系

目的探讨结直肠癌患者外周血循环肿瘤细胞CK20阳性表达与术后患者肿瘤复发和转移的关系。方法选取2010年6月至2011年5月,211例结直肠癌患者作为研究对象,以CK20作为结直肠癌患者的肿瘤细胞标志物,采用Cellular FACTT方法检测术后外周血循环肿瘤细胞CK20表达情况,并结合临床病理指标及术后随访资料对患者肿瘤进展因素和临床预后进行相关性分析。结果 211例结直肠癌患者术后外周血循环肿瘤细胞CK20阳性率为59.2%(125/211),且与肿瘤TNM分期及肝转移密切相关(P<0.001);外周血循环肿瘤细胞阳性检出患者3年术后复发或转移率和无瘤生存期均明显劣于阴性检出患者(P<0.001);进一步多因素Cox风险模型分析发现,外周血肿瘤细胞CK20阳性可能是结直肠癌患者3年无瘤生存的独立影响因素(P<0.05)。结论外周血循环肿瘤细胞CK20阳性率与结直肠癌患者的肿瘤分期和肝转移密切相关,是结直肠癌患者3年无瘤生存转归的独立影响因素,对预测结直肠癌患者预后具有一定的临床意义。     

老年结直肠癌患者手术风险及预后

目的分析老年结直肠癌患者的临床病理特点及影响手术预后因素。方法手术治疗的结直肠癌患者300例,分析不同年龄结直肠癌患者的临床及病理资料,采用多因素COX分析评价影响老年组术后复发的危险因素及3、5年生存率和无病生存率。结果≥70岁组高中分化腺癌比例、TNM分期Ⅲ~Ⅳ期、区域淋巴结转移、腹腔及远处转移发生率均显著高于70岁组(P0.05)。COX多因素分析提示,TNM分期、组织类型、区域淋巴结转移、腹腔及远处转移均为影响≥70岁结直肠癌患者预后的相关因素。≥70岁组3年生存率为57.66%(79/137),3年无病生存率为48.91%(67/137);5年生存率为24.82%(34/137),5年无病生存率为21.17%(29/137)。结论应对TNM分期高、组织类型为高中分化腺癌、存在区域淋巴结转移、腹腔及远处转移的≥70岁结直肠癌患者加强术后监测,以降低术后复发率,提升患者术后生存率。     

结直肠癌患者门静脉血TXA2、VEGF、CEA水平变化对手术预后的预测价值

背景结直肠癌(colorectal cancer, CRC)是国内外发病率和死亡率均靠前的恶性肿瘤,是世界性的重大公共卫生问题,它排在新诊断癌症的第三位,也是第四位癌症致死原因.积极探索一种结直肠癌术后肝转移的有效预测指标是目前研究重点与难点,若能通过某种方法早期检测出肝脏内肿瘤细胞的微转移,并采取有效的干预和综合治疗,这将会极大的改善结直肠癌患者预后.目的探讨CRC患者门静脉血血栓素A2 (thromboxane A2,TXA2)、血管内皮生长因子(vascular endothelial growth factor, VEGF)、癌胚抗原(carcino embryonic antigen,CEA)水平变化对手术预后的预测价值.方法选取2017-05/2019-11我院112例CRC手术患者,根据术后6 mo有无肝转移分为观察组(肝转移, n=21)与对照组(无肝转移, n=91).比较两组临床资料、门静脉血TXA2、VEGF、CEA水平,分析CRC患者术后肝转移影响因素,评估门静脉血各指标水平与临床病理参数的相关性、对CRC患者术后肝转移的预测价值及与预后的关联性.结果门静脉血TXA2、VEGF、CEA水平:观察组对照组(P 0.05);年龄、病灶大小、组织学分级、T分期、区域淋巴结转移、脉管瘤栓、手术方式、辅助化疗、门静脉血TXA2、VEGF、CEA水平均为CRC患者术后肝转移影响因素(P0.05); CRC术后肝转移患者门静脉血TXA2、VEGF、CEA水平与年龄、病灶大小、T分期、区域淋巴结转移及脉管瘤栓呈正相关关系,与组织学分级呈负相关关系(P0.05);门静脉血TXA2、VEGF、CEA水平联合预测CRC患者术后肝转移AUC最大,为0.929;结直肠癌患者门静脉血TXA2、VEGF、CEA高水平患者与低水平患者术后生存率相比,差异无统计学意义(P0.05).结论门静脉血TXA2、VEGF、CEA水平高表达可能参与CRC术后肝转移过程,上述指标联合检测可为临床预测CRC术后肝转移与预后提供数据支持.     

结直肠癌淋巴微转移的判定及相关因素分析

目的探讨结直肠癌患者淋巴结微转移灶的特点及与临床病理参数间的关系。方法收集2010年1月至2014年1月我院收治的65名结直肠癌患者的临床资料,对其淋巴结进行免疫组化检测,分析微转移灶与临床病理特征间的相关性。结果对65例结直肠癌患者的624枚淋巴结进行了CK19及CEA免疫组化染色。结果显示:淋巴结阳性表达率为21.79%(136/624),52.31%(34/65)的患者淋巴结呈阳性表达;CK19阳性表达率为15.54%(97/624),46.15%(30/65)的患者淋巴结染色为阳性;CEA阳性表达率为20.19%(126/624),47.69%(31/65)的患者淋巴结染色为阳性。淋巴结CK19及CEA阳性表达与肿瘤大小相关(P0.05),而与年龄、性别、肿瘤部位、TNM分期、分化程度及有无血管浸润无显著相关性(P0.05)。结论免疫组化方法是检测结直肠癌微转移的有效手段,结直肠癌的微转移的发生与有无淋巴结浸润及肿瘤大小相关。     

CCL2表达与同时性结直肠癌肝转移的相关性分析

目的观察结直肠癌原发瘤CCL2表达与同时性结直肠癌肝转移的相关性。 方法检索1999年1月至2003年12月中国医学科学院肿瘤医院临床病理资料完整的结直肠癌病例,最终197例纳入研究。其中对照组104例,同时性肝转移组93例。对照病例定义为结直肠癌术后随访5年以上没有复发转移者。采用免疫组织化学法检测结直肠癌原发瘤CCL2表达,单因素和多因素分析CCL2和临床病理因素与结直肠癌肝转移的相关性。 结果多因素分析显示,肿瘤大小、淋巴结分期、CEA和CCL2表达是预示结直肠癌肝转移的独立危险因素(P<0.05),CCL2高表达者肝转移风险是低表达者的5.828倍(95% CI：2.212～15.355)。CCL2与其他临床病理因素的相关性分析表明,CCL2表达仅与肝转移相关(P<0.05),与肿瘤浸润深度、淋巴结分期和CEA均未见统计学差异(P>0.05)。 结论同时性结直肠癌肝转移与肿瘤大小、淋巴结分期、CEA和CCL2表达密切相关。结直肠癌肝转移中CCL2的作用机制可能与常见临床病理因素不同。     

结直肠癌肺转移的外科治疗

结直肠癌是我国的常见恶性肿瘤,发病率居第三位。约20%的结直肠癌初诊时就伴有远处转移,其中肺是最常见的转移部位之一。大量文献表明,对于结直肠癌伴有局限性肺转移的患者手术切除转移病灶,术后的5年生存率为21%～64%。存在其他可切除转移灶并不是手术禁忌。对于手术耐受良好的肺部转移瘤术后复发的患者,再次手术仍可生存获益。距离病灶0.5cm～1.0cm楔形切除是肺外周型病灶的经典术式。对于结直肠癌肺转移瘤手术胸腔淋巴结清扫仍有不同观点。目前公认的结直肠癌肺转移预后不良的因素包括：多发肺转移瘤、癌胚抗原水平升高、胸内淋巴结转移、无瘤间期较短。基于精准医学的个体化治疗将是未来进一步改善预后的关键。     

Factors predicting long-term survival in colorectal cancer patients with a normal preoperative serum level of carcinoembryonic antigen

Purpose

The aim of this study was to determine which clinicopathological factors influenced the long-term survival after potentially curative resection of colorectal cancer patients with a normal preoperative serum level of carcinoembryonic antigen (CEA).

Methods

A total of 1,732 patients who underwent curative surgery for primary nonmetastatic colorectal cancers from 1997 to 2009 were analyzed. Of these patients, 1,128 (65.1 %) had normal level of preoperative CEA (<5 ng/mL). The predicting factors for survival were analyzed.

Results

When the serum CEA cutoff value was set at 2.4 ng/mL (median value), the high CEA groups displayed a higher percentage of older patients, males, large-diameter tumors, advanced T and N categories, and positive perineural invasion, compared to the low CEA groups. Multivariate analysis revealed that age, T category, N category, number of lymph nodes retrieved, operative method, lymphovascular invasion, perineural invasion, postoperative chemotherapy, and preoperative serum CEA level ≥ 2.4 ng/mL were independent predictors for 5-year overall survival, while tumor location, tumor size, T category, N category, lymphovascular invasion, and perineural invasion were independent predictors for 5-year disease-free survival.

Conclusions

Even if patients with colorectal cancer have a normal preoperative CEA before surgery, CEA may be useful for prognostic stratification using 2.4 ng/mL as the cutoff.     

Cancer Invasion to Auerbach’s Plexus is an Important Prognostic Factor in Patients with pT3-pT4 Colorectal Cancer

Purpose By defining perineural invasion of colorectal cancer as invasion to Auerbach’s plexus, we examined the usefulness of this pathologic finding as a prognostic factor. Methods A total of 509 consecutive patients who underwent curative surgery for pT3 or pT4 colorectal cancer between May 1997 and December 2001 were reviewed. All the surviving patients were followed for more than five years. All the pathologic findings, including perineural invasion, were described prospectively in the pathology report forms. Results Perineural invasion was detected in 132 of 509 patients (26 percent) and was significantly associated with lymph node status, lymphatic invasion, and venous invasion. Incidences of local and systemic recurrence were significantly higher in patients with perineural invasion than in those without perineural invasion. The disease-free survival of the perineural invasion-positive group was significantly poorer than that of the perineural invasion-negative group for Stages II and III colon cancer, irrespective of the use of adjuvant chemotherapy. This improved disease-free survival also was seen in patients with Stage II rectal cancer not treated with adjuvant chemotherapy. There was a nonsignificant difference in disease-free survival for Stage II rectal cancer and Stage III rectal cancer treated with chemotherapy, that of the perineural invasion-positive group being poorer. Multivariate analysis showed that lymph node status, perineural invasion, depth of invasion, and cancer site were significant prognostic factors. Conclusions Perineural invasion defined as cancer invasion to Auerbach’s plexus is an important prognostic factor for colorectal cancer. Supported by a Grant-in-Aid for Cancer Research from the Ministry of Health, Labor and Welfare of Japan.     

Incidence and prognostic implications of isolated tumor cells in lymph nodes from patients with Dukes B colorectal carcinoma

PURPOSE: Lymph node metastasis in colorectal carcinoma is an important prognostic factor, yet the prognostic relevance of occult tumor cells in lymph nodes has not elucidated. This study was performed to investigate the correlation between isolated tumor cells in lymph nodes and malignancy potential in patients with Dukes B colorectal carcinoma and, thus, to determine whether presence of isolated tumor cells in lymph nodes has a prognostic significance. METHODS: To evaluate the incidence of isolated tumor cells in lymph nodes in patients with Dukes B colorectal carcinoma, 1,808 lymph nodes taken from 93 patients (19.4 per case) were assessed by immunohistochemical technique using a monoclonal antihuman cytokeratin (MNF 116). Clinicopathologic parameters and prognosis were compared between patients with and without isolated tumor cells. RESULTS: Isolated tumor cells were identified in 54 lymph nodes from 29 patients (31.2 percent) by the immunostaining. No correlations were observed between the incidence of positive isolated tumor cells and various clinicopathologic parameters, including preoperative carcinoembryonic level, tumor site and size, histologic differentiation, pT stage, vascular invasion and lymphatic invasion, and perineural invasion. There was no difference in five-year survival estimated by Kaplan-Meier life-table method between positive and negative groups for isolated tumor cells (82.8 and 85.9 percent, respectively). Multivariate analyses showed that sex (P = 0.0236), serum carcinoembryonic level ( 5 ng/ml, P = 0.0002), and lymphatic vessel invasion (P = 0.0002) were significant factors in the survival time. CONCLUSION: Immunohistochemical staining with an anticytokeratin antibody is useful in identifying isolated tumor cells in lymph nodes missed in routine hematoxylin-eosin staining, but clinically it seems to be of little prognostic value in patients with Dukes B colorectal carcinoma. Thus, this immunostaining technique does not offer a significant benefit of different strategies for additional therapy or follow-up during conventional pathologic staging using hematoxylin-eosin staining.     

Tumor Invasion of Lymph Node Capsules in Patients with Dukes C Colorectal Adenocarcinoma

Purpose The objective of this study was to investigate the correlation between the microscopic findings of positive lymph nodes, especially focusing on capsular invasion, and the outcome after curative surgical resection of colorectal cancer. Methods We analyzed 480 positive lymph nodes from 155 consecutive patients with Stage III colorectal cancer to determine the frequency and significance of lymph node capsular invasion. Recurrence-free and cancer-specific survival rates were assessed in the patients with and without lymph node capsular invasion. Results Between April 1995 and December 2000, 406 consecutive patients with primary colorectal cancer underwent curative resection. Regional lymph node metastases were present in 155 cases (38.2 percent). During the median follow-up period of 4.8 years, 41 patients (26.5 percent) developed recurrent disease and 28 patients died of cancer. Lymph node capsular invasion was detected in one or more lymph nodes from 75 cases (48.3 percent). The five-year recurrence-free rate was 56.1 percent in this group, whereas in the 80 patients without lymph node capsular invasion the rate was 88 percent (P<0.01). Features that were associated with recurrent disease were greater number of positive lymph nodes, venous invasion in primary tumor, infiltrative growth pattern of intranodal tumor, and presence of lymph node capsular invasion. Multivariate analysis identified lymph node capsular invasion as the only significant prognostic factor for recurrence. In multivariate analysis with regard to survival, lymph node capsular invasion, venous invasion, and number of positive nodes remained as significant prognostic factors. Conclusions Lymph node capsular invasion, determined by routine hematoxylin-eosin staining, is a potent prognostic factor in Stage III colorectal cancer. Read in part at the meeting of The International Society of University Colon and Rectal Surgeons, Budapest, Hungary, June 9, 2004. Reprints are not available.     

Detection of lymph nodes micrometastases in Dukes＇ A and B colorectal cancer using anti-cytokeratin antibodies AE1／AE3

AIM: To detect lymph nodes micrometastases and analyze its correlation with clinicopathological parameters in Dukes' A and B colorectal cancer patients. METHODS: One hundred and fourteen patients with colorectal cancer (Dukes' A 16; Dukes' B 98) undergoing curative operation without histological lymph nodes metastases were studied between 2001 and 2003. A total of 2 481 lymph nodes were analyzed using monoclonal cytokeratin antibody AE1/AE3 (DAKO, Carpinteria, CA) for immunohist-ochemistry. RESULTS: In total, 33 (29%) patients were positive for cancer cell by immunohistochemistry. In 31 (94%) patients of them positive nodes showed single tumor cell or small groups of tumor cells; and tumor deposits measuring 0.2 and 0.37 mm in diameter in another 2 (6%) patients. Micrometastases were mainly located in the subcapsular sinus or paracortical sinus. There was no correlation between the positive lymph nodes and gender, age, tumor site, tumor size, histological type, histological grade, invasion depth, Dukes' staging and microsatellite instability (P>0.05). CONCLUSION: Our findings suggest that immunohist-ochemical technique using monoclonal cytokeratin antibody AE1/AE3 may be a sensitive and reliable method for detecting lymph nodes micrometastases in Dukes' A and B colorectal cancer. The clinical significance of lymph nodes micrometastases is still not confirmed.     

Expression of phosphatase regenerating liver 3 is an independent prognostic indicator for gastric cancer

AIM： To investigate the prognostic significance of phosphatase regenerating liver 3 （PRL-3） protein expression in gastric cancer.
METHODS： PRL-3 expression in paraffin-embedded tumor specimens from 293 patients with gastric cancer was studied retrospectively by immunohistochemistry. Nonoclonal antibody specifically against PRL-3, 3B6, was obtained with hybridoma technique.
RESULTS： Positive PRL-3 expression was detected in 43.3% （227 of 293） of gastric cancer cases. High expression of PRL-3 was positively correlated with tumor size, depth of invasion, vascular/lymphatic invasion, lymph node metastasis, high TNM stage and tumor recurrence. Patients with positive PRL-3 expression had a significantly lower 5-year survival rate than those with negative expression （28.3% vs 52.9%, P 〈 0.0001）. Patients who received curative surgery, and with positive PRL-3 expression had a significant shorter overall survival and disease-free disadvantage over patients with negative expression （hazard ratio of 16.7 and 16.6, respectively; P 〈 0.0001 for both）. Multivariate analysis revealed that PRL-3 expression was an independent prognostic indicator for overall and disease-free survival of gastric cancer patients, particularly for survival in TNM stage Ⅲ patients.
CONCLUSION： PRL-3 expression is a new independent prognostic indicator to predict the potential of recurrence and survival in patients with gastric cancer at the time of tumor resection,     

Lack of influence of cytokeratin-positive mini micrometastases in "Negative Node" patients with colorectal cancer: findings from the national surgical adjuvant breast and bowel projects protocols R-01 and C-01

PURPOSE: Results of the few extant reports concerning the clinical significance of so-called "occult micrometastases" of lymph nodes of patients with Dukes A and B colorectal cancer have been variable. We examined the presumably negative nodes of a larger cohort of such patients who were enrolled in the National Surgical Adjuvant Breast and Bowel Project clinical trials R-01 and C-01 for the influence of what we preferably designate as nodal mini micrometastases on parameters of survival. METHODS: Mini micrometastases were detected by immunohistochemical staining of the original lymph node sections with anticytokeratin A1/A3 in a total of 241 Dukes A and B patients with rectal and 158 with colonic cancers. Their frequency, as well as that of nuclear and histologic grades, and an estimation of their relationship to relative risks were correlated with overall and recurrence-free survival by univariate and multivariate analyses. RESULTS: Nodal mini micrometastases were detected in 73 of 399 (18.3 percent) patients of this cohort. They failed to exhibit any significant relationship to overall or recurrence-free survival. No association between the assessments of tumor differentiation and mini micrometastases was found. Nuclear and histologic grades also failed to further discriminate overall or recurrence-free survival in patients with A or B stages of colonic or rectal cancers in this cohort. CONCLUSION: The immunohistochemical demonstration of nodal mini micrometastases failed to discriminate high- and low-risk groups of patients with colorectal cancer who were designated as being node-negative after routine pathologic examination.     

Detection of Lymphatic Micrometastases in Patients With Stages I and II Colorectal Cancer: Impact on Five-Year Survival

PURPOSE: Despite having removed the whole macroscopic disease (curative intent surgery), one of five patients with Stages I and II colorectal cancer will develop recurrence. Lymphatic micrometastases detected by immunohistochemistry could be one of explanation for recurrence and cancer-related death in patients without lymph node involvement at light microscopy. However, the biologic importance of micrometastases remains unclear. This study was designed to determine the impact of micrometastases in five-year survival in patients with Stages I and II colorectal cancer.METHODS: This retrospective study included patients operated on between May 1989 and January 1999 for colorectal cancer without histopathologic lymph node involvement. Patients who received any adjuvant therapy were excluded. Immunohistochemical staining of the lymph nodes was performed with antipancytokeratin antibodies. Follow-up data were obtained from the clinical database and death certificates. Survival was estimated by the Kaplan-Meier method and compared by the log-rank test.RESULTS: Micrometastases were observed in 26 of 90 patients (28.9 percent). The mean follow-up time was 90.7 (range, 11–160) months. Seventeen cancer-related deaths occurred during follow-up (18.9 percent), 6 of them in patients with micrometastases (23.1 percent) and 11 in patients without micrometastases (17.2 percent; P = 0.559). Cancer-specific five-year survival was 87 percent in the whole group and 81 percent in patients positive for micrometastases vs. 90 percent in negative patients (P = 0.489).CONCLUSIONS: The presence of micrometastases in patients with Stages I and II colorectal cancer seems not to have any impact on cancer-specific survival.Supported by the Apertus Research Program (Andromaco Pharmaceutical Company) and by The National Public Grant (FONDECYT #1000556).     

Prognostic value of micrometastases in esophageal and colorectal carcinoma (a clinical experience)

BACKGROUND/AIMS: The term "micrometastases" has been confused in many aspects. While the influence of lymph node metastases in esophageal and colorectal cancer is well known, the presence and importance of micrometastases is under debate. We investigated micro lymph node invasion in two different kinds of digestive tumors with very high mortality, and identified its possible repercussion on patient survival. METHODOLOGY: Lymph nodes of two groups of patients N0 on routine histopathology after radical resection (R0): 21 with esophageal carcinoma (Group I), and 21 with colorectal carcinoma (Group II), were studied by immunohistochemistry using monoclonal antibodies directed against cytokeratins of wide spectrum. The results were classified as positive or negative and compared with patient survival. RESULTS: Five of twenty-one (5/21) patients in group I and eight of twenty-one (8/21) in group II were positive for micrometastases. Median survival time in the positive esophageal group was 9.5 months vs. 68 in the negative one (p=0.16). Median survival time in the positive subset colorectal group was 54.5 months vs. 76.8 in the negative subgroup (p=0.5). Our results did not show statistical differences in survival time between patients positive or negative for micrometastases; however it is evident, especially in the esophageal cancer group, that there is a negative tendency of positive micrometastases on survival time. CONCLUSIONS: The presence of micrometastases in lymph nodes of patients N0 after conventional histopathology is frequent. Our preliminary results did not allow definitive conclusions but we may suppose its negative influence on patient survival.