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Results for “lymph node metastasis”

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PubMed2005

Value of preoperative serum CA125 in early-stage adenocarcinoma of the uterine cervix without pelvic lymph node metastasis.

OBJECTIVE: This investigation attempted to clarify the value of preoperative serum CA125 in predicting histopathological prognostic factors for early-stage cervical adenocarcinoma without lymph node metastasis. METHODS: This study initially surveyed 163 patients with clinical stage Ib or IIa cervical adenocarcinoma treated with radical hysterectomy and pelvic lymphadenectomy. Of the 163 patients, 116 had preoperative serum CA125 levels, and 14 had pelvic lymph node metastasis. The investigation group comprised 102 lymph node-negative patients. RESULTS: A cutoff value of 26 U/ml was obtained after the discriminant function analysis for identifying patients with positive lymph vascular space invasion (LVSI) or depth of stromal invasion > or =2/3 thickness. Multivariate analysis revealed that among the preoperative clinicopathological variables, including age, tumor size, parametrial invasion, and CA125 level, raised CA125 most significantly influenced the assessment of the LVSI (P = 0.040) and depth of cervical stromal invasion (P = 0.002). CONCLUSIONS: In early-stage cervical adenocarcinoma with negative pelvic lymph node metastasis, preoperative serum CA125 levels at the cutoff value of 26 U/ml impacted the determination of the poor histopathological prognostic factors.

Adenocarcinoma↗

PubMed1993

[Evaluation of lymph nodes metastasis in lung cancer by endoscopic ultrasonography].

The value of endoscopic ultrasonography (EUS) in diagnosing lymph node metastasis in lung cancer was investigated. The endoscope is composed of an ultrasonic linear array transducer (7.5 MHz). EUS findings of 101 lymph nodes in 25 patients with non-small cell lung cancer who underwent thoracotomy and mediastinal lymph node dissection were reviewed. EUS data on the size, shape, boundary and internal echo of the lymph nodes was correlated with the histological findings. From the characteristics of their shape, boundary and internal echo, hyperechoic lymph nodes with unclear boundaries were histologically metastasis negative and lobulative lymph nodes were metastasis positive. Using the criteria of a long-plus-short diameter > or = 17 mm and a ratio of long to short diameter < 1.8, or a lobulative shape, rates of 91% sensitivity, 91% specificity and 91% accuracy were obtained. EUS combined with CT increases the accuracy of preoperative diagnosis of lymph node metastasis.

Adenocarcinoma↗

PubMed2003

[Effect of E1A gene on in vitro growth inhibition and radiochemosensitivity of lymph node metastasis cells of human head and neck squamous cell carcinoma].

BACKGROUND & OBJECTIVE: Adenovirus type 5 early region 1A (E1A) gene has been found to be a tumor suppression gene recently. The protein of E1A gene regulates the expression of many cellular genes positively or negatively, and possesses the activities of inducing differentiation of tumor cell, reversing of malignant phenotype, anti-carcinogenesis and anti-metastasis. Study of E1A protein on the treatment of lymph node metastasis of human head and neck squamous cell carcinoma (HNSCC) was not reported. This study was designed to investigate the growth inhibition and radiochemosensitivity of E1A gene on human lymph node metastasis cell line 686LN-1 derived from the patient with human tongue squamous cell carcinoma in vitro and its mechanism. METHODS: The pcDNA3-E1A recombinant plasmid, designed for high-level expression of E1A gene in a variety of eukaryotic cell lines,was transfected into 686LN-1 cells mediated by lipofectamine. To observe the growth inhibition of E1A gene on the cells, the growth curve and doubling time were investigated. Cells before and after transfection were treated with cisplatin, paclitaxel, bleomycin, and 5-fluorouracil (5-FU) for 24 hours or irradiation, respectively, then the changes of sensitivity were tested by MTT assay. The redistributions of cell cycle were analyzed by flow cytometry. Immunocytochemical staining was used to detect the expression of p53 and HER-2/neu. RESULTS: Compared with the vector-transfected cells (686LN-1-vect cells), the E1A-transfected cells (686LN-1-E1A cells) grew slowly, and the doubling time elongated (1.41-fold). 686LN-1-E1A cells showed distinct sensitivity to the anticancer drugs and irradiation. According to the IC(50) value, the sensitivity of 686LN-1-E1A cells increased approximately 8-fold to cisplatin, 20-fold to bleomycin, 10-fold to paclitaxel, 1-fold to irradiation compared with 686LN-1-vect cells. However, the sensitivity to 5-FU did not change. The cell cycle was dramatically arrested at G(2)/M phase in the 686LN-1-E1A cells. E1A gene remarkably suppressed the expression of HER-2/neu gene in 686LN-1-E1A cells. CONCLUSION: E1A gene can significantly inhibit the growth rate of lymph node metastasis cell line 686LN-1 of HNSCC. Moreover, it also slightly enhance the cell sensitivity to antitumor drugs and irradiation. These functions of E1A gene may be associated with its ability to suppress the HER-2/neu expression and to arrest the cell at G(2)/M phase.

Adenovirus E1A Proteins↗

PubMed2003

A case of small mucosal gastric carcinoma with lymph node metastasis: a case report.

We have experienced a case of small early mucosal gastric cancer with lymph node metastasis. The patient was a 75-year-old woman diagnosed as having early gastric cancer type 0 IIa on the greater curvature of the antrum. We performed distal gastrectomy, with Billroth I method reconstruction. The tumor lesion was on the greater curvature of the antrum. Metastasis was discovered in the number 4d lymph node, histologically. The tumor was type 0 IIa confined to the mucosa, 1.0 cm in diameter and differentiated histological type, and no ulcer scar could be seen in tumor lesion. However, the tumor was massively invading to the mucosal membrane, with positive lymph vessel invasion, and was of mixed histological type. This was a rare case of small early mucosal cancer 1.0 cm in diameter with lymph node metastasis.

Aged↗

PubMed2000

Role of surgery for gallbladder carcinoma with special reference to lymph node metastasis and stage using western and Japanese classification systems.

The role of radical resection in the treatment of gallbladder carcinoma was examined with special reference to lymph node metastasis using two classifications: one proposed by the American Joint Committee on Cancer (AJCC) and the other by the Japanese Society of Biliary Surgery (JSBS). Histologic evaluations for the depth of tumor invasion (T), lymph node metastasis (N), stage, and follow-up for a mean period of 38 months (range 4-185 months) were completed in 52 patients with gallbladder carcinoma who underwent surgical resection from 1982 to 1997. The definition of T was similar in the two classifications. The extent of nodal involvement (N, AJCC; n, JSBS), stage, and survival were examined. In the absence of lymph node metastasis, the 5-year survival rate reached 71%. The 5-year survival rate in patients with involved nodes confined to the hepatoduodenal ligament, posterosuperior pancreaticoduodenal region, or along the common hepatic artery (N1 and part of N2 by AJCC; nl and n2 by JSBS) approximated 28%. In contrast, postoperative survival was poor in the presence of more extensive nodal involvement (rest of N2 by AJCC; n3 and n4 by JSBS), with no 2-year survivors. The definition of stage I was the same in both classifications, and all patients in this stage are alive. The 5-year survival rates in stages II and III by the AJCC were 70.7% and 22.4%, respectively, and those by JSBS 61.9% and 23.1%, respectively. Thus the survival rates in stages I to III were essentially similar irrespective of the staging system. Stage IV showed significantly worse survival than stage III by the JSBS classification. In contrast, the differentiation of stage IV from III by the AJCC was not significant because of the better survival in stage IV that contained any T with nodal involvement in the posterosuperior pancreaticoduodenal region and along the common hepatic artery. Radical resection should be considered for patients with stage I to III disease defined by either classification and applied to the tumor invasion up to T3 with nodal involvement confined to the hepatoduodenal ligament, posterosuperior pancreaticoduodenal region, and along the common hepatic artery. The role of radical surgery seems to be limited in patients with more extensive tumor invasion or lymph node metastasis.

Adult↗

PubMed2001

Differential diagnosis of a lateral cervical cyst and solitary cystic lymph node metastasis of occult thyroid papillary carcinoma.

We present a case of solitary cystic lymph node metastasis from an occult thyroid papillary carcinoma mimicking a lateral cervical cyst, and a case of thyroid papillary carcinoma with a true lateral cervical cyst. Based on a comparison of the radiographical findings of the two cases, differential diagnosis between cystic lymph node metastasis of papillary carcinoma and branchial cyst is discussed.

Adult↗

PubMed1995

Proximal subtotal gastrectomy for the treatment of carcinoma of the upper third of the stomach: its indications based on lymph node metastasis and perigastric lymphatic flow.

To clarify the indications for a proximal subtotal gastrectomy in the treatment of carcinoma in the upper third of the stomach based on lymph node metastases, 1055 patients in whom either a D2 or greater lymph node removal was performed were reviewed. In the patients in which the lesion was confined to the upper stomach and did not invade beyond the muscularis propria of the stomach wall, no metastases to either the lymph nodes above and below the pylorus or the lymph nodes along the greater curvature were observed. A lymphatic flow study revealed a minimal flow to these nodes from the upper stomach in patients without lymph node metastasis, but in cases with lymph node metastases the lymphatic flow changed. The indications for a proximal subtotal gastrectomy for a carcinoma of upper third of the stomach therefore must fulfill the following two conditions: (1) The deepest layer of cancerous invasion does not extend beyond the muscularis propria of the stomach wall, and (2) No macroscopic evidence of lymph node metastasis can be detected during surgery.

Case-Control Studies↗

PubMed1987

[A study of lymph node metastasis in gastric cancer--a new method for fixing resected specimens with methylene blue formalin].

Lymph node metastasis in 171 cases after a radical resection of the gastric cancer have been studied by means of examining specimens of these lymph nodes fixed with methylene blue formalin. The number of the resected lymph nodes in a single case was 50.3 on the average. By the Appleby method this number was 82.8. The rate of metastasis (the number of cases with lymph node metastasis measured against the number of patients) was 43.9%. The frequency of metastasis (the number of metastasized nodes versus the number of dissected nodes) was 11.3%. When classified by location no difference was noted, but in the group which showed an infiltration of a macroscopic type or an undifferentiated adenocarcinoma, the rate of metastasis and the frequency of metastasis was found to be higher than in the group with a non-infiltration type or a well-differentiated adenocarcinoma. Although the metastatic rate of perigastric nodes (No. 1-6 was higher than in the other lymph node group (No. 7-11), no difference was recognized between both groups in the frequency of metastasis.

Formaldehyde↗

PubMed2003

Fas ligand expression in cervical adenocarcinoma: relevance to lymph node metastasis and tumor progression.

OBJECTIVE: Adenocarcinoma of the cervix carries a worse prognosis than its squamous counterpart. In particular, tumors with lymph node metastasis have a miserably poor prognosis. Fas ligand (FasL) could allow the tumor cells to evade host immune surveillance and would thus promote tumor survival and possibly metastasis formation. We decided to compare FasL expression in cervical adenocarcinoma with lymph node status to determine whether FasL plays a role in lymph node metastases. METHODS: Using immunohistochemistry, we investigated FasL expression in sections of formalin-fixed, paraffin-embedded tissue from 24 cervical adenocarcinomas. We also studied sections of seven cases with lymph node metastases. The percentage of FasL-positive cells in each tumor was recorded. FasL expression in cervical adenocarcinoma was compared with lymph node status. Statistical analysis was performed by using the Fisher exact test and the Kaplan-Meier method. RESULTS: FasL expression was detected in 62.5% (15 of 24) of primary lesions. Significantly higher incidence of positive FasL reactivity was demonstrated in 10 of 11 tumors with lymph-vascular space (P = 0.0188), in 10 of 10 with deep stromal invasion (P = 0.0015), and in 8 of 9 cancers with lymph node metastasis (P = 0.0481). All 9 metastatic cervical adenocarcinoma in the lymph nodes showed FasL immunoreactivity in 60.7 +/- 17.7% of the metastatic cancer cells, and 7 (78%) of these had FasL immunoreactivity in greater than 50% of the cells. The survival times of patients with FasL-expressing cervical adenocarcinomas were significantly reduced compared to patients with low FasL-expressing tumors (P = 0.0018). CONCLUSIONS: These findings indicate that FasL plays an important role in immune evasion, and progression and metastasis of cervical adenocarcinoma.

Adenocarcinoma↗

PubMed2000

[T1, T2 squamous or adenocarcinoma of the lung:characteristics of lymph node metastasis and its clinical significance].

OBJECTIVES: To investigate the frequency, distribution and features of lymph node metastasis in T(1)/T(2) squamous or adenocarcinoma of the lung, and to provide evidence for extensive dissection of lymph nodes. METHODS: 254 patients with T(1)/T(2) squamous or adenocarcinoma of the lung underwent R2 surgery plus extensive dissection of hilar, interlobular and mediastinal lymph nodes according to the grouping system proposed by Naruke. RESULTS: 1 685 groups of lymph nodes were dissected. The metastatic rates of N(1) and N(2) was 20.0% and 10.2% respectively. Significant difference existed between T(1) and T(2) tumors (P < 0.01). No N(2) metastasis was found in T(1) squamous cell carcinoma. N(2) metastatic rates were 22.0% in squamous cell carcinoma and 40.9% in adenocarcinoma (P < 0.01). 64.3% of squamous carcinoma spread to only one group of N(2) nodes, and over 3 groups of lymph nodes were positive in 46.2% of adenocarcinoma. Saltatory metastasis accounted for 57.5% of N(2) metastasis. 13.6% of N(2)-positive tumors in upper lobes metastasized to the lower mediastinum, whereas 51.6% of N(2)-positive cancers in the lower lobes spread to the upper mediastinum. CONCLUSIONS: The frequency of lymph nodes metastasis increases with the growth of tumors. Metastasis in adenocarcinoma occurs more frequently than in squamous carcinoma. Tumor at any site can metastasize to the distant mediastinum. Except for T(1) squamous cancer, radical surgery can be achieved only by extensive dissection of ipsilateral intrapulmonary and mediastinal lymph nodes.

Adenocarcinoma↗

PubMed2002

[T(1) carcinoma of the lung: characteristics of lymph node metastasis and its clinical significance].

OBJECTIVE: To investigate the frequency, distribution and features of lymph node metastasis in T(1) carcinoma of the lung, and to provide evidence for lymph node dissection. METHODS: Two hundred and fifteen patients with T(1) carcinoma of the lung underwent R2 surgery plus extended dissection of hilar, interlobular and mediastinal lymph nodes according to the mapping system developed by Naruke. RESULTS: 1 674 groups of lymph nodes were dissected. The metastatic rates of N(1) and N(2) were 11% and 6% respectively. Lymph node metastatic rates in carcinoma of the lung with maximum diameters less than 1.5 cm and between 1.6 cm approximately 3.0 cm were 5% and 8% respectively. N(1) and N(2) metastasis was not found in squamous cell carcinoma of the lung with a maximum diameter less than 1.5 cm. N(2) metastatic rates were 5% in squamous cell carcinoma 23% in adenocarcinoma and 3/9 in small cell carcinoma, the difference being significant (P < 0.01). 3/4 squamous cell carcinoma invaded only one group of N(2) nodes, but over 3 groups of lymph nodes were positive in 40% of adenocarcinoma. Saltatory metastasis accounted for 41% of N(2) metastasis. Fourteen percent of N(2)-positive tumors in upper lobes metastasized to the lower mediastinum, whereas 60% of N(2)-positive cancers in lower lobes invaded the upper mediastinum. CONCLUSIONS: The frequency of lymph node metastasis increases with the growth of tumors. Metastasis in adenocarcinoma occurs more frequently than in squamous cell carcinoma, but most common in small cell carcinoma. Tumors at any site can metastasize to the distant mediastinum. Except for squamous cell carcinoma with maximum diameter less than 1.5 cm which are likely to be cured without lymph node dissection, other types of T(1) carcinoma of the lung need extended lymph node dissection.

Adult↗

PubMed1996

[The MRI of cervical lymph node metastasis with malignant tumor of the head and neck].

A prospective diagnostic study on cervical lymph node metastasis from malignant tumor of the head and neck using MRI was performed for 62 cases in order to assess the potential or limitation of MRI for demontrating the pathological cervical lymph node. The double blind method was used in the study. The result reveals MRI has obvious higher sensitivity (85.7%), higher specificity (94.8%) and higher accuracy (89.6%) than palpation. Besides changes in size and shape of the lymph nodes, the intensity of MRI inside lymph nodes was altered showing, mixed hypo-iso-intensity in T1WI and hyper intensity in T2WI. Thus, MRI will probably play an important role as a staging modality in the detection of malignant lymph nodes metastasis.

Adult↗

PubMed1990

Cervical lymph node metastasis: assessment of radiologic criteria.

To estimate the accuracy of different radiologic criteria used to detect cervical lymph node metastasis in patients with head and neck carcinoma, seven different characteristics of 2,719 lymph nodes in 71 neck dissection specimens from 55 patients were assessed. Three lymph node diameters, their location, their number, the presence of a tumor, and the amount of necrosis and fatty metaplasia were recorded. The minimal diameter in the axial plane was found to be the most accurate size criterion for predicting lymph node metastasis. A minimal axial diameter of 10 mm was determined to be the most effective size criterion. The size criterion for lymph nodes in the subdigastric region was 1 mm larger (11 mm). Groups of three or more borderline nodes were proved to increase the sensitivity but did not significantly decrease the specificity. Radiologically detectable necrosis (3 mm or larger) was found only in tumorous nodes and was present in 74% of the positive neck dissection specimens. Shape was not a valuable criterion for the radiologic assessment of the cervical lymph node status.

Carcinoma, Squamous Cell↗

PubMed2000

Tumor thickness as a predictor of cervical lymph node metastasis in squamous cell carcinoma of the lower lip.

Tumor thickness is a relatively new prognostic factor that has been investigated for lower lip cancer. This study was performed in 27 patients, 13 of whom had histopathologically confirmed cervical metastasis, to investigate whether tumor thickness could be used as a predictor of cervical lymph node metastasis. The mean tumor thickness of those cases with neck metastasis was 5.60 mm (SD = 2.24), and the mean thickness of cases without neck metastasis was 3. 79 mm (SD = 1.68). The difference between tumor thicknesses of both groups was found to be statistically significant (P < 0.05). The tumor thickness of 5 mm was determined as a cutoff point, above which the cervical lymph node metastasis rate was significantly increased. As a conclusion, tumor thickness is an objective histopathologic factor that is easily reproducible; it significantly influences cervical lymph node metastasis in lower lip cancer, and it may be used in the assessment of prognosis.

Carcinoma, Squamous Cell↗

PubMed2004

Clinicopathological features influencing pelvic lymph node metastasis and vaginal and parametrial involvement in patients with carcinoma of the cervix.

PURPOSE: This study was undertaken to evaluate clinical and pathologic findings that predicted pelvic lymph node metastasis and parametrial and vaginal involvement in patients with stage IB carcinoma of the cervix. METHODS: 71 patients with diagnosis of stage IB (FIGO) cervical cancer were prospectively studied from December 1997 to August 2002. The patient's age, clinical stage (IB1 or IB2), histological classification, grade of differentiation, tumor volume, and lymphatic vascular space invasion (LVSI) were evaluated. Statistical methods included chi2 test and Fisher's exact test to evaluate significant differences between the groups. The level of significance was set at p < 0.05. RESULTS: The clinical stage was IB1 in 51 patients (71.8%) and IB2 in 20 patients (28.2%). The histological classification identified squamous cell carcinoma in 60 patients (84.5%) and adenocarcinoma in 11 patients (15.5%). The average tumoral volume was 22.8 +/- 24.3 cm3 (0.3-140.0 cm3). The tumor was well differentiated (G1) in 8 (11.3%), moderately differentiated (G2) in 40 (56.3%) and poorly differentiated in 23 (32.4%) of the cases. The presence of LVSI was detected in 14 patients (19.7%) and was associated with pelvic lymph node metastasis and vaginal and parametrial involvement (p = 0.002, p = 0.001 and p < 0.001; respectively). The average number of positive pelvic lymph nodes was significantly higher in the patients with LVSI compared with patients without LVSI (2.47 +/- 2.8 vs. 0.33 +/- 0.74; p = 0.001). There was no association of age, clinical stage, histological classification, grade of differentiation or tumor volume with pelvic lymph node metastasis and vaginal and parametrial involvement. CONCLUSION: The presence of LVSI is significantly associated with pelvic lymph node metastasis and vaginal and parametrial involvement in patients with stage IB cervical carcinoma.

Adenocarcinoma↗

PubMed2002

Coexpression of MUC1 with p53 or MUC2 correlates with lymph node metastasis in colorectal carcinomas.

The alteration of the mucin profile have been known to play a role in colorectal carcinogenesis. MUC1 is up-regulated and MUC2 is down-regulated in colorectalcarcinomas. Overexpression of p53 is frequently noted in colorectal carcinomas with deep invasion or lymph node metastasis. However, there have been few reports about the association between MUC1, MUC2, and p53 expression with respect to the metastatic potential. This study was aimed to investigate the relationship of MUC1, MUC2, and protein p53 expressions with clinicopathological factors in colorectal carcinomas. Expressions of MUC1, MUC2, and p53 protein were examined immunohistochemically. Of total 97 cancers, 44 (45%) were MUC1 positive, 39 (40%) were MUC2 positive and 58 (59%) showed a p53 overexpression. Coexpression of MUC1 with p53 and dual expression of MUC1 with MUC2 were associated with a higher frequency of lymph node metastasis (p<0.05). The right colon showed a higher MUC1 positivity and frequent lymph node metastasis than the left colon (p<0.05). These results suggest that the coexpression of MUC 1 with p53 or MUC2 are involved in regional lymph node metastasis in colorectal carcinomas. The high expression of MUC1 in the right colon cancer was revealed to relate with lymph node metastasis.

Adult↗

PubMed1977

Value of prophylactic oophorectomy in advanced breast cancer with parasternal lymph nodes metastasis.

In order to improve the poor prognosis of advanced breast cancer cases with positive parasternal lymph nodes metastasis, prophylactic oophorectomy was performed in 25 unselected cases. In a retrospective study on the breast cancer cases operated on from 1958 to 1969, comparison of eight advanced breast cancer cases with positive parasternal lymph nodes metastasis after radical mastectomy of Halsted type and parasternal lymph nodes dissection with, and 17 cases without prophylactic bilateral oophorectomy was made with respect to the survival rate, the survival time pattern by Mantel-Haenszel's procedure in their entirety and the recurrence rate. These results suggest the effectiveness of prophylactic oophorectomy for the advanced breast cancer.

Breast Neoplasms↗

PubMed2002

Multiparametric in situ mRNA hybridization analysis of gastric biopsies predicts lymph node metastasis in patients with gastric carcinoma.

We examined the expression level of several genes that regulate different steps in metastasis formation in formalin-fixed, paraffin-embedded biopsies of 189 primary human gastric carcinomas prior to surgical resection in patients in whom lymph node metastasis was not evident by endoscopic ultrasound or computed tomography (CT) scan. The expressions of epidermal growth factor receptor (EGF-R), vascular endothelial growth factor (VEGF), matrix metalloproteinase (MMP)-2 and E-cadherin were examined by a colorimetric in situ mRNA hybridization technique. The integrity of the mRNAs was verified, leaving 161 (85.2%) patients for study. After gastrectomy, 82 patients had positive lymph nodes and 79 patients had negative lymph nodes. The concurrent expression levels of MMP-2 and E-cadherin mRNAs were significantly higher and lower, respectively, in the metastatic tumors than the non-metastatic tumors. Expression of EGF-R and VEGF was not different between the metastatic and non-metastatic tumors. However, when only the intestinal-type of gastric cancer was evaluated, the level of VEGF mRNA was significantly higher in tumors associated with lymph node metastasis than in those without metastasis. However, a high MMP-2:E-cadherin ratio significantly correlated with lymph node metastasis in both types of gastric cancer. These results suggest that multiparametric in situ hybridization analysis for several metastasis-related genes may allow the preoperative prediction of lymph node metastasis from gastric cancer.

Adult↗