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PubMedDate not supplied

Further evidence that altered p16/CDKN2 gene expression is associated with lymph node metastasis in squamous cell carcinoma of the esophagus.

Esophageal squamous cell carcinoma (ESCC) has high malignant potential with a poor outcome. Lymph node metastasis is the most useful indicator for predicting the outcome of ESCC. The p16/MTS1/CDKN2 gene and the cyclin D1/PRAD-1 gene cooperatively regulate CDK4-mediated phosphorylation of RB protein in the cell cycle. We immunohistochemically detected p16, cyclin D1, and RB expressions in both primary lesions and metastatic lymph nodes in ESCC. Among the 50 ESCC primary lesions, 24 (48%) were positive for p16, while 26 (52%) were negative for p16. Sixteen (32%) were p16-positive, 34 (68%) were p16-negative among the 50 ESCC metastatic lymph nodes. Eight cases (16%) were p16-positive in primary lesion and p16-negative in lymph node, however, no cases that was p16-negative in the primary tumor exhibited p16-positivity in metastatic lymph nodes (p < 0.0001). Seventeen (34%) of the 50 ESCC primary lesions were cyclin D1-positive, while 33 (66%) were cyclin D1-negative. Twenty-four (48%) were cyclin D1-positive, 26 (52%) were cyclin D1-negative among the 50 metastatic lymph nodes. Five cases (10%) were cyclin D1-positive in primary lesion and cyclin D1-negative in lymph node, and 12 cases (24%) were cyclin D1-negative in primary lesion and cyclin D1-positive in lymph nodes. Nine cases (18%) were RB-negative in 50 primary lesions, and the rate of loss of RB expression in metastatic lymph nodes was not markedly higher than in primary lesions. Thirty-nine (78%) of 50 primary lesions and 46 (92%) of 50 metastatic lymph nodes had altered expression of at least one of the three G1 control genes. Tumor cell with disruption of these cell cycle regulators can get a growth advantage and metastatic potential during tumor progression, especially p16/CDKN2 alterations may be associated with lymph node metastasis in ESCC. These results also suggest that tumor cells in metastatic lymph nodes may have more aggressive proliferation and higher malignant potential than tumor cells in primary lesions.

Adult↗

PubMed1986

Lymph node metastasis in cancer of the cervix: a preliminary report.

Accurate assessment of lymph node metastasis in cervical cancer is imperative to treatment plan. A histologic sampling method is suggested in which surgically excised lymph nodes are dissected at multiple levels before paraffin embedding. This approach proves to be a more sensitive procedure than the current bisection method in detecting metastasis.

Female↗

PubMed2001

(99)mTc-tetrofosmin SPET in the detection of both primary breast cancer and axillary lymph node metastasis.

The aim of this study was to evaluate the usefulness of (99m)Tc-tetrofosmin single-photon emission tomography (SPET) in the detection of both primary breast cancer and axillary lymph node metastasis. We studied 192 consecutive patients in whom primary breast cancer was suspected on the basis of mammography and/or physical examination. After intravenous injection of 740 MBq (99m)Tc-tetrofosmin, both planar and SPET scintimammography was performed in all patients using a rectangular dual-head gamma camera equipped with low-energy, high-resolution, parallel-hole collimators. In 175 patients with breast cancer at histology, the per-lesion overall sensitivity of SPET and planar imaging for the detection of breast cancer was 95.8% and 75.9% (P<0.0005), respectively. The sensitivity of SPET and planar imaging was, respectively, 96.5% and 79.5% in palpable (P<0.0005) and 90% and 45% in non-palpable lesions (P<0.01). With regard to lesion size, the sensitivity of SPET and planar imaging was, respectively, 90.5% and 45.2% in lesions < or =10 mm ( P<0.0005), 95.3% and 81.4% in lesions of 11-20 mm (P<0.005), 100% and 84.6% in lesions of 21-30 mm (P<0.05) and 100% and 95.8% in lesions >30 mm (P>0.05). In the remaining 17 patients with benign mammary lesions at histology, per-lesion overall specificity of SPET and planar imaging was 76.2% and 85.7% (P>0.05), respectively. Neither SPET nor planar imaging showed false-positive results in non-palpable lesions or in those < or =10 mm. In 173 breast cancer patients submitted to axillary lymph node dissection (ALND), per-axilla overall sensitivity of SPET and planar imaging in the detection of axillary lymph node metastasis was 93% and 52.3% ( P<0.0005), respectively. The sensitivity of SPET and planar imaging was, respectively, 100% and 82.6% in palpable nodes (P>0.05), 90.5% and 41.3% in non-palpable nodes (P<0.0005), 92.8% and 35.7% in the presence of < or =3 nodes ( P<0.0005) and 93.2% and 68.2% in the presence of >3 nodes (P<0.005). The specificity of SPET and planar imaging was 91% and 100% (P<0.05), respectively. (99m)Tc-tetrofosmin SPET appears to be a reliable method for the detection of both primary BC and axillary lymph node metastasis, and its diagnostic accuracy exceeds that of (99m)Tc-tetrofosmin planar scintimammography. The use of SPET is particularly important in the identification of small non-palpable primary carcinomas and metastatic axillae with < or =3 non-palpable lymph nodes. More extensive use of SPET appears warranted in the management of breast cancer patients.

Axilla↗

PubMed1993

[Evaluation of radiotherapy for bone and lymph node metastasis in post-operative hepatocellular carcinoma--three case reports].

Successful radiotherapy was performed for three post-operative hepatocellular carcinoma patients, two with bone metastases and one with lymph node metastasis. One patient had severe high back pain and paraplesia caused by spinal compression with bone metastasis on 5th thoracic vertebra. After a total of 45 Gy irradiations, the back pain was removed, and 9 months later the patient recovered from the paraplesia gradually and could start rehabilitation. A second patient with multiple bone metastases was very concerned about skull metastasis and severe headache. Radiation reduced the headache and the tumor vanished. A third patient with cervical lymph node metastasis was irradiated. The size of the lymph node was decreased but did not disappear. We concluded that radiotherapy for distant metastases (ie, bone, skin) in a hepatocellular carcinoma patient, can be an effective therapeutic procedure for patient complaints.

Bone Neoplasms↗

PubMed1992

Variables correlated with the risk of lymph node metastasis in early rectal cancer.

To ascertain the risk of lymph node metastasis (LNM) from early rectal cancer, the authors retrospectively analyzed 154 patients with pT1 or pT2 rectal cancer treated by radical resection. Gross and microscopic pathologic characteristics of the primary tumor were examined as predictors of LNM. Comparisons were done by Fisher's test; significance was defined as a P value of less than 0.05. The incidence of LNM for T1 and T2 tumors was 3 of 26 (12%) and 28 of 128 (22%), respectively. LNM occurred significantly less often in well-differentiated cancers (0 of 12.0%). The incidence of LNM for T1/T2 tumors without lymphatic vessel invasion (LVI) or blood vessel invasion (BVI) (20 of 119, 17%) was significantly less than that for T1/T2 tumors with LVI or BVI (10 of 32, 31%). None of the T1 tumors without LVI or BVI had LNM. There was a trend toward decreased LNM for sessile nonulcerated tumors compared with nonpolypoid, exophytic, or ulcerated lesions (P = 0.06). Tumor size and colloid histologic characteristics were not significant predictive features for LNM. The data suggest that local excision alone is adequate for well-differentiated or moderately differentiated T1 rectal cancer in the absence of LVI or BVI and for well-differentiated T2 tumors. Radical resection or local excision combined with pelvic radiation therapy may be more appropriate for the remainder of early cancers.

Adenocarcinoma↗

PubMed2005

[The expression of matrix metalloproteinases (MMPs), tissue inhibitor of metalloproteinases (TIMPs) and angiogenesis in relation to the depth of tumor invasion and lymph node metastasis in submucosally invasive colorectal carcinoma].

BACKGROUND/AIMS: Lymph node (LN) metastasis occurs in approximately 10% of patients with submucosally invasive colorectal carcinoma. This study was performed to determine the role of matrix metalloproteinases (MMPs), tissue inhibitors of metalloproteinases (TIMPs) production and microvessel formation on the LN metastasis in submucosally invasive colorectal carcinoma. METHODS: A total of forty-one subjects with surgically resected submucosally invasive colorectal carcinoma were included in this study. Immunohistochemical staining of MMP-2, MMP-9, TIMP-1, TIMP-2, and urokinase-type plasminogen activator were performed. Angiogenesis was evaluated by counting the number of microvessels in each pathologic specimen as identified by CD34 immunohistochemical staining. RESULTS: The depth of submucosal invasion was not significantly correlated with the expression of MMP-2, MMP-9, TIMP-1, TIMP-2, or urokinase-type plasminogen activator, but the microvessel count was significantly correlated with the absolute depth of invasion (r=0.312, p<0.05). Upregulation of TIMP-2 was positively correlated with adjacent lymphatic invasion (p<0.05) and increased TIMP-2 expression was correlated with LN metastasis in submucosally invasive colorectal carcinoma (p=0.088). CONCLUSIONS: These results suggest that the expression of TIMP-2 and the microvessel count may be useful parameters for considering additional surgery after endoscopic treatment of submucosally invasive colorectal carcinoma.

Adult↗

PubMed2006

Frozen section is superior to imprint cytology for the intra-operative assessment of sentinel lymph node metastasis in stage I breast cancer patients.

BACKGROUND: A standard intra-operative procedure for assessing sentinel lymph node metastasis in breast cancer patients has not yet been established. PATIENTS AND METHODS: One hundred and thirty-eight patients with stage I breast cancer who underwent sentinel node biopsy using both imprint cytology and frozen section were analyzed. RESULTS: Seventeen of the 138 patients had sentinel node involvement. Results of imprint cytology included nine false negative cases (sensitivity, 47.1%). In contrast, only two cases of false negatives were found on frozen section (sensitivity, 88.2%). There were two false positive cases identified by imprint cytology (specificity, 98.3%). On the other hand, frozen section had 100% specificity. CONCLUSION: These findings suggest that frozen section is superior to imprint cytology for the intra-operative determination of sentinel lymph node metastasis in stage I breast cancer patients.

Journal Article↗

PubMed1989

[Retroperitoneal lymph node metastasis in patients with ovarian cancer].

From 1979 to 1987 retroperitoneal lymph node dissection was performed at the Tokyo University Hospital in 41 cases (pelvic lymph node biopsy was done in 4 cases, pelvic lymphadenectomy in 23 cases, pelvic and paraaortic lymphadenectomy up to the renal vessels in 14 cases) of Stage Ia to IV ovarian cancer following cytoreductive surgery. The incidence of retroperitoneal positive nodes was 11.1% (2/18) in Stage I, 50.0% (5/10) in Stage II, 50.0% (5/10) in Stage III and 0% (0/3) in Stage IV (FIGO criteria without considering the pathologic findings of retroperitoneal lymph nodes). The positive rate of lymph node involvement in Stage II and Stage III was significantly higher than that in Stage I. The tumors involving both ovaries were more likely to metastasize to retroperitoneal lymph nodes. Enlargement of tumors and increased ascites were not the risk factors of retroperitoneal lymph node metastasis. These data suggest that the occurrence of retroperitoneal lymphatic spread in ovarian cancer is comparable to that in uterine cancer and increased by involvement of both ovaries and extension to other pelvic tissues.

Adult↗

PubMed2005

Lymphatic vessel density and lymph node metastasis in prostate cancer.

BACKGROUND: Few data are available examining the significance of prostatic lymphatic vessel density (LVD) to lymph node metastasis in patients with prostate cancer. The purpose of this study was to determine the distribution of lymphatic vessels in non-carcinomatous prostate tissue, and investigate the relationship between LVD and lymph node status in prostate cancer. METHODS: LVD, identified by D2-40 immunostaining, was evaluated in non-carcinomatous prostates (n = 7) and prostate cancer (n = 37). The staining pattern of D2-40 was compared with that of another lymphatic vessel marker, vascular endothelial growth factor (VEGF) receptor-3, and a blood vessel endothelial marker, CD34, in adjacent sections. RESULTS: The D2-40 antigen, podoplanin, was expressed exclusively in lymphatic vessels within tumor and normal tissue in all specimens. There was no overlap between cell staining for D2-40 and CD34. Peritumoral LVD and peritumoral lymphatic invasion were significantly associated with lymph node metastasis. VEGF receptor-3 was expressed in a subset of D2-40+ lymphatic vessels. CONCLUSIONS: We have demonstrated that peritumoral lymphatic vessels are likely to serve as major conduits for nodal metastasis in prostate cancer using D2-40 to decorate lymphatic endothelium marker podoplanin. Lack of coexpression of podoplanin and VEGF receptor-3 in some lymphatic vessels suggests the heterogeneity of lymphatic endothelial cells in prostate tissue.

Adenocarcinoma↗

PubMed2004

The expression of vascular endothelial growth factor-A and -C, and receptors 1 and 3: correlation with lymph node metastasis and prognosis in tongue squamous cell carcinoma.

We determined whether the expression of VEGF-A and -C and their receptors, Flt-1 and Flt-4, are associated with primary tumor size, regional lymph node metastasis, distant metastasis and prognosis in patients with tongue carcinoma. The expression of VEGF-A and -C, and their receptors, Flt-1 and Flt-4, in biopsy specimens taken from 73 patients with tongue carcinoma were examined by immunohistochemical staining. VEGF-A expression was associated with distant failure and VEGF-C expression correlated with locoregional recurrence and distant failure. Furthermore, VEGF-C expression was associated with lymph node recurrence in N0 cases. Multivariate analysis revealed that VEGF-C expression was an exclusively independent factor influencing lymph node metastasis. In terms of the overall 5-year survival rate, there was no significance correlation between the overall 5-year survival rate and expression of VEGF-A, Flt-1 and Flt-4 expression, whereas there was a significant difference between VEGF-C-positive and VEGF-C-negative cases (VEGF-C-positive, 51.7% vs VEGF-C-negative, 94.2%). Furthermore, there was a significant difference between positive and negative expression for both VEGF-A and VEGF-C. Multivariate analysis revealed that lymph node metastasis and VEGF-C expression were exclusive, independent factors influencing the overall survival rate. VEGF-C expression may be a predictive factor of regional lymph node recurrence and prognosis in patients with tongue carcinoma.

Age Distribution↗

PubMed2006

Impact of lymph node metastasis on survival in patients with pathological T1 carcinoma of the ampulla of Vater.

To determine the prognostic factors for patients with pathological T1 (pT1) carcinoma of the ampulla of Vater, 36 consecutive patients with carcinoma of the ampulla of Vater who underwent surgery were retrospectively analyzed in terms of clinicopathological features. The overall 5-year Kaplan-Meier survival in all patients was 50.2%, and the median survival of all patients was 64.0 months. Factors favorably influencing a long-term outcome were the absence of lymph node metastasis (P < 0.0001), the absence of ulcer formation of the tumor (P = 0.0062), and the absence of tumor invasion into the duodenum (P = 0.0025) and the pancreas (P = 0.0098). In a multivariate analysis, lymph node metastasis was the only predictor of survival (P = 0.0023). In the pT1 stage patients, 20% of the patients had lymph node metastasis, and their survival was statistically poor compared to the pT1 patients without lymph node metastasis (P = 0.017). As for survival after the operation, there was no significant difference between pancreatoduodenectomy and pylorus-preserving pancreatoduodenectomy.

Aged↗

PubMed2004

In vitro investigation of detectability of colorectal lymph nodes and diagnosis of lymph node metastasis in colorectal cancer using B-mode sonography.

PURPOSE: The aim of this in vitro study was to assess the feasibility of using high-frequency sonography to identify colorectal lymph nodes and to diagnose colorectal lymph node metastasis. METHODS: In part 1 of this study, resected colorectal tissues from 13 patients with colorectal cancer were scanned in a water bath using B-mode sonography performed at high frequency (10 MHz) to identify lymph nodes. The colorectal tissues were then carefully dissected to remove all lymph nodes. Detectability was calculated as the ratio of the number of sonographically detected nodes to the total number of histopathologically confirmed nodes. Student's t test was performed to compare sizes between these groups; a p value of less than 0.05 was considered significant. In part 2, 4 features of lymph nodes identified on B-mode sonography--size, shape, border, and echogenicity--and their combinations were evaluated for their ability to diagnose lymph node metastasis. Discriminant and receiver operating characteristic curve analyses were performed. RESULTS: In part 1, B-mode sonography performed in vitro detected 79 (48%) of the 165 histopathologically identified lymph nodes and 34 (87%) of the 39 histopathologically identified metastatic nodes. The mean size, or mean longest axis (+/- standard deviation), of the sonographically detected nodes (6.4 +/- 2.9 mm) was significantly larger than that of undetected nodes (3.6 +/- 1.7 mm; p < 0.01). In part 2, the most effective feature distinguishing metastatic from nonmetastatic lymph nodes was echogenicity, followed by size, shape, and border. However, a combination of at least 2 features (eg, echogenicity and size) provided better distinction of nodes than did any 1 feature. In the receiver operating characteristic curve of the 4-feature combination, an increase in sensitivity is accompanied by a decrease in specificity: at a sensitivity of 100%, specificities decreased to 60% or less. However, even with the optimal combination of features, the sensitivity and specificity did not both reach 85% at any operating point. CONCLUSIONS: The results of this node-by-node in vitro study show the current limitations and potential of sonography for assessing colorectal lymph nodes. High-frequency sonography may be insufficient for identifying lymph node metastasis in colorectal cancer.

Adenocarcinoma↗

PubMed1999

Higher frequencies of numerical aberrations of chromosome 17 in primary gastric cancers are associated with lymph node metastasis.

We investigated the correlation between the frequency of numerical aberrations of chromosome 17 and clinicopathological features of gastric cancer. The copy number of chromosome 17 was examined with fluorescence in-situ hybridization (FISH) in frozen specimens from 100 primary gastric cancers. Chromosomal numerical aberrations were diagnosed as chromosomal loss (single signal) or gain (triple or more signals), in each cell. The frequency of numerical aberrations of chromosome 17 correlated significantly with the depth of invasion (P < 0.01), lymph node metastasis (P < 0.0001), lymphatic invasion (P < 0.001), and venous invasion (P < 0.01). Numerical aberrations of chromosome 17 were associated with lymph node metastasis in 32 early gastric cancers. Multiple regression analysis identified the depth of invasion and numerical aberrations of chromosome 17 as independent significant determinants of lymph node metastasis. Our findings suggest that alterations in chromosome 17 may be linked with tumor progression in primary gastric cancer. Our results also indicate that numerical aberrations of chromosome 17 detected by FISH provide important information about the malignant potential (in particular, lymph node metastasis) of primary gastric cancer.

Adult↗

PubMedDate not supplied

Lymph node metastasis as a prognostic factor in laryngeal cancer.

The authors reviewed the prognostic importance of several lymph node metastasis-related factors. The presence of lymph node metastasis from laryngeal cancer significantly reduces the probability of regional control and survival. Proper management of the neck remains a therapeutic dilemma because there are no precise means for evaluating lymph nodes. A comprehensive neck dissection adjuvant radiotherapy has been relied as the proper treatment for cases with positive lymph nodes. On the other hand, there is no consensus over whether or not and how to perform an elective neck treatment in patients with laryngeal carcinoma. Several variables related to cervical lymph node involvement and their implication on prognosis were studied in the literature (site, size, extracapsular extension, number). In an analysis of 3-year survival rates showed that patients with clinically detectable regional metastasis (N stage) exhibited poorer disease free interval (DFI) and overall survival (OS) than those classified as N-. Also patients with high number, or larger, or ruptured metastatic nodes experienced poor prognosis (marginally significant statistically). The highest impact on survival were exhibited by the involvement of contralateral lymph nodes adn extracapsular extension. It is our opinion that cases with clinically positive nodes should be submitted to a comprehensive neck dissection (either classical or modified); at least a selective dissection as a staging procedure when the supraglottis is involved. It is a advisable to perform an elective comprehensive neck dissection when a satisfactory clinical assessment cannot be made or when there are factors that would prevent adequate follow-up.

Humans↗

PubMedDate not supplied

Comparative genomic hybridization analysis suggests a gain of chromosome 7p associated with lymph node metastasis in non-small cell lung cancer.

We analyzed the chromosomal gains and losses that occur in 30 non-small cell lung carcinomas by comparative genomic hybridization. Their chromosomal imbalances showed histological type-specific patterns in adenocarcinomas and in squamous cell carcinomas. The genetic changes in non-small cell lung carcinoma were also strongly dependent on metastasis to lymph node. The average numbers of chromosomal alterations were increased from 6.2 to 9.1 along with the presence of metastasis, and it gave rise to the increased copy number in specific chromosomes. In particular, a novel imbalance at 7p12-21 was recognized in a half of carcinoma with metastasis, although no genetic alteration was observed in 15 non-metastasizing lung carcinoma tested here.

Adenocarcinoma↗

PubMed1998

Preoperative ultrasound study in predicting lymph node metastasis for endometrial cancer patients.

OBJECTIVE: The objective of this study was to evaluate the efficacy of preoperative ultrasound (US) findings such as tumor size, status of myometrial invasion, and intratumoral "resistance index" (RI) in predicting lymph node metastasis in endometrial carcinoma patients. METHODS: Forty-two patients with endometrial cancer were enrolled. All patients underwent total abdominal hysterectomy, pelvic lymph node dissection or sampling, and para-aortic lymph node sampling. Two-dimensional and color Doppler US were performed before surgery to measure tumor size, depth of myometrial invasion, and intratumoral arterial RI. Formalin-fixed, paraffin-embedded pathologic slides from surgical specimens were reviewed by a senior pathologist to evaluate histologic type and grade, depth of myometrial invasion, cervical involvement, lymph-vascular emboli, and status of lymph node metastasis. RESULTS: There were 12 patients with pelvic and/or para-aortic lymph node metastases and 30 patients without nodal metastases. Patients with tumors larger than 2.5 cm by US (11/12 vs 14/30, P = 0.008), more than half myometrial invasion by US (9/12 vs 5/30, P < 0.001), and intratumoral RI values less than 0.4 by US (12/12 vs 4/30, P < 0.001) had a significantly higher incidence of nodal metastases as compared with patients with tumors smaller than 2.5 cm, no or superficial myometrial invasion, and RI values higher than 0.4, respectively. Multiple regression analysis showed that only intratumoral RI values less than 0.4 were significantly correlated with nodal metastasis (P < 0.001, r2 = 0. 650). We used the intratumoral RI value as the parameter to evaluate nodal metastasis in endometrial cancer patients. Twelve of sixteen patients with intratumoral RI values <0.4 had a high incidence of nodal metastases. None of the 26 patients with intratumoral RI values >0.4 had nodal metastases. CONCLUSIONS: Preoperative ultrasound features can offer important information for predicting lymph node metastasis in endometrial cancer patients. Patients with tumors with intratumoral RI values less than 0.4 should be highly suspected of having lymph node metastases and further management such as pelvic lymph node dissection or postoperative pelvic radiotherapy would be needed for these patients.

Adult↗

PubMed2005

Aberrant methylation of HLTF, SOCS-1, and CDH13 genes is shown in colorectal cancers without lymph node metastasis.

PURPOSE AND METHODS: In this study, we examined the combined methylation status of HLTF, SOCS-1, and CDH13 in 61 resected primary colorectal cancers using methylation-specific polymerase chain reaction and correlated the number of methylated genes with the clinicopathologic features of affected patients. RESULTS: We found a significant difference in lymph node metastasis (P = 0.020) when we compared the number of methylated genes in colorectal cancers with lymph node metastasis to those without it. CONCLUSIONS: Colorectal cancers without lymph node metastasis frequently exhibited the aberrant methylation of HLTF , SOCS-1 , and CDH13 genes.

Adult↗

PubMed1987

cis-Diamminedichloroplatinum II based combination chemotherapy for the control of extensive paraaortic lymph node metastasis in cervical cancer.

A prospective study was carried out in nine consecutive patients with extensive paraaortic lymph node metastasis from locally advanced cervical cancer. Patients were treated with pelvic radiation and weekly cis-platinum during radiation followed by cis-platinum based combination chemotherapy given on a monthly basis. Three weeks after completion of pelvic radiation and weekly cis-platinum, and prior to monthly combination chemotherapy, pelvic examination confirmed a 100% local response rate: 78% complete and 32% partial response. All patients have been followed for greater than or equal to 1 year or until death and only 22% (2) are alive NED while 56% (5) are dead of cervical cancer and 22% (2) are alive with cervical cancer. Although there was a significant response to local pelvic tumor by pelvic radiation and weekly cis-platinum, it is concluded that this protocol would not result in a significant increase in 5-year survival for patients with extensive paraaortic lymph node metastasis, because of the inability to control disease outside of the radiated area.

Adult↗