Clinical significance of immunohistochemically detected lymph node micrometastasis in patients with histologically node-negative esophageal carcinoma: a multi-institutional study |
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Authors: | Hitoshi Shiozaki Yoshiyuki Fujiwara Toshihiro Hirai Hisahiro Matsubara Masaki Mori Tsutomu Nakamura Yukihiro Nakanishi Shoji Natsugoe Tsuyoshi Noguchi Soji Ozawa Yutaka Shimada Seiji Udagawa Hideaki Yamana Masahiko Yano Takushi Yasuda Akio Yanagisawa |
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Institution: | (1) Research Committee on Clinical Application of Biological Property of Esophageal Cancers, Japanese Society for Esophageal Diseases, Japan;(2) Department of Surgery, Kinki University School of Medicine, 377-2 Ohno-Higashi, Sayama, Osaka 589-0014, Japan |
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Abstract: | Background In esophageal carcinoma, the clinical significance of immunohistochemically (IHC)-detected lymph node (LN) micrometastasis
is still controversial. We designed this multicenter study to determine the clinical significance of IHC-detected LN micrometastasis
in esophageal carcinoma.
Methods The subjects were 164 patients with histopathologically confirmed LN-negative esophageal carcinoma from eight hospitals. A
similar IHC technique was used in all institutions, and micrometastasis was diagnosed by a researcher at each hospital as
well as independently by pathologists with special interest in esophageal carcinoma.
Results IHC-related micrometastasis in LN was considered positive in 51 (31%) patients by the researchers and in 25 (15%) by the pathologists.
The latter micrometastases were further classified into a single (n = 13) and clusters (n = 12) of immunopositive-LN. Kaplan–Meier analysis showed that researcher-based diagnosis of micrometastasis had no significant
impact on prognosis whereas the cluster-type micrometastasis diagnosed by pathologists had a significant impact on prognosis.
Conclusions We speculate that the inconsistent results of IHC analyses reported in the literature are caused by the use of different definitions
of micrometastasis and the subjective nature of diagnosis of micrometastasis, i.e., dependence on the examiner. Our multiinstitutional
study also indicates that the morphological aspects of immunostained cells should be considered when assessing micrometastasis
in LN by IHC and that only LN with clusters of IHC-positive cells are prognostically significant in esophageal carcinoma. |
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Keywords: | Esophageal carcinoma Lymph node Micrometastasis Immunohistochemistry |
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