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Risk of prostate carcinoma death in patients with lymph node metastasis.

BACKGROUND: The presence of lymph node metastasis is a poor prognostic sign for patients with prostate carcinoma. Results of published reports on survival among patients with lymph node metastasis are difficult to assess because of treatment selections. The extent to which lymph node status will have an impact on a patient's survival is uncertain. METHODS: The authors analyzed 3463 consecutive Mayo Clinic patients who underwent radical prostatectomy and bilateral pelvic lymphadenectomy for prostate carcinoma between 1987 and 1993. Of these patients, 322 had lymph node metastasis at the time of surgery, and 297 lymph node positive patients also received adjuvant hormonal therapy within 90 days of surgery. The progression free rate and the cancer specific survival rate were used as outcome endpoints in univariate and multivariate Cox proportional hazards models. The median follow-up was 6.3 years. Progression was defined by elevation of serum prostate specific antigen (PSA) > or = 0.4 ng/mL after surgery, development of local recurrence, or distant metastasis documented by biopsy or radiographic examination. RESULTS: The 5-year and 10-year progression free survival rates (+/- standard error [SE]) for patients with lymph node metastasis were 74% +/- 2% and 64% +/- 3%, respectively, compared with 77% +/- 1% and 59% +/- 2%, respectively, for patients without lymph node metastasis. The 5-year and 10-year cancer specific survival rates were 94% +/- 1% and 83% +/- 4%, respectively, compared with 99% +/- 0.1% and 97% +/- 0.5%, respectively, for patients without lymph node metastasis. Among patients with a single lymph node metastasis, the 5-year and 10-year cancer specific survival rates were 99% +/- 1% and 94% +/- 3%, respectively. After adjustment for extraprostatic extension, seminal vesicle invasion, Gleason grade, surgical margins, DNA ploidy, preoperative serum PSA concentration, and adjuvant therapy, the hazard ratio for death from prostate carcinoma among patients with a single lymph node metastasis compared with patients who were without lymph node metastasis was 1.5 (95% confidence interval, 0.5-5.0; P = 0.478), whereas the hazard ratio for death from prostate carcinoma was 6.1 (95% confidence interval, 1.9-19.6; P = 0.002) for those with two positive lymph nodes and 4.3 (95% confidence interval, 1.4-13.0; P = 0.009) for those with three or more positive lymph nodes. There was no significant difference in the progression free survival rate among patients with or without lymph node metastasis in multivariate analysis after controlling for all relevant variables, including treatments (hazard ratio,1.0; 95% CI, 0.7-1.3; P = 0.90). CONCLUSIONS: Patients with prostate carcinoma who have multiple regional lymph node metastases had increased risk of death from disease, whereas patients with single lymph node involvement appeared to have a more favorable prognosis after radical prostatectomy and immediate adjuvant hormonal therapy. Excellent local disease control was achieved by using combined surgery and adjuvant hormonal therapy in patients with positive lymph nodes.

Adult↗

Histopathological study of lymphatic invasion in squamous cell carcinoma (O-1N) with high potential of lymph node metastasis.

The process of lymph node metastasis was studied in an animal model (termed O-1N) that was successfully established using a metastatic tumor to the submandibular lymph node from a chemically induced squamous cell carcinoma of the hamster tongue. The model has been maintained by serial transplantation of metastatic tumors into the buccal pouch. Lymphovascular invasion of transplanted O-1N in the tongue was examined in serial histologic sections. Lymphatic vessels were distinguished from blood vessels by Masson's trichrome stain for vascular smooth muscle, BSA-I lectin binding for vascular endothelium, and laminin and type IV collagen immunostaining for the vascular basement membrane. Transplanted tumors enlarged progressively with invasion of surrounding tissues of the tongue and resulted in lymph node metastasis in all animals with successful takes. Local growth of the tumors in the tongue was accompanied by stromal proliferation with abundant dilated lymphatic vessels which contained clusters of tumor cells. On serial sections, the carcinoma cell clusters in lymphatics in the close proximity of tumor nests were in continuity with adjacent tumor nests, whereas such continuity was not recognized in those occurring apart from tumor nests. The formation of isolated carcinoma cell clusters resulting from disintegration of elongated processes of tumor nests with invasion of lymphatics and subsequent transport in lymphatics and deposition in lymph nodes in clusters were well demonstrated in other serial sections. The key step of lymph node metastasis therefore appears to be direct invasion of lymphatic vessels by tumor cells, similar to their invasion of adjacent tissues but different from the way that blood cells escape through vessel walls. Proliferation of lymphatics around tumor nests and transport of tumor cells in clusters would also contribute to the production of metastatic deposits in lymph nodes.

Animals↗

[Pathological features of lymph node metastasis. 2) From morphological aspects].

Lymph node metastasis is important because of its early appearance and prognostic significance. In this paper the mechanism of development of metastasis, tissue reaction with metastatic cells, and role of lymph node metastasis in cancer spread are described briefly. Lymph node metastasis proceeds when cancer cells invade lymphatic vessels. These cells lodge in the lymphatic sinus where tumor cells adhere to and breach the sinusoidal walls and migrate into the parenchyma. Integrin(s), CD44, and/or carbohydrates of tumor cells and extracellular matrix components such as laminin and type IV collagen, hyaluronic acid, and lectins of the sinus wall become involved in the adherence of cancer cells. Their binding may induce matrix metalloproteinase production from cancer cells, resulting in degradation of surrounding reticular fibers. Lymph nodes sometimes react with tumors, exhibiting follicular hyperplasia, sinus histiocytosis, lymphoid cell depletion, fibrosis, and angiogenesis of lymph nodes. Such tissue reactions may suppress cancer spread but in turn may augment the aggressiveness of cancer cells. It is not yet possible to determine which reaction will occur. In early cancer, lymph node metastasis occurs based on mainly anatomical-mechanical factor, while in advanced cancer, seed-soil factor plays an important role on development of the metastasis.

Female↗

Correlation of lectin binding with lymph node metastasis in oral cancers.

Lymph node metastasis is an important factor that influences the treatment policy and prognosis of oral cancers. The cell membrane is known to play a role in the metastatic process. The aim of the present study was to evaluate the relationship of lectin binding frequency of oral cancer cells to their capacity to metastasize to the lymph node. Smears collected from tumours of 66 untreated patients were stained with Jackfruit lectin (JFL) conjugated with horseradish peroxidase (HRP), with diaminobenzidine dihydrochloride (DAB) as the visualant. The frequency of cells showing lectin binding was evaluated. The results showed that tumours with a high frequency of JFL binding cells had higher risk of lymph node metastasis (RR = 1.5). It was also found that a combined score integrating the percentage of lectin binding cells with known clinical parameters, like primary tumour size, local invasion and histological subgroup, had better utility than any of these individually in assessing risk of lymph node metastasis. The density of sugar residues on the cell surface may be of importance in determining the lymph node metastatic potential of oral cancers, and the present study suggests the need for further research in this area.

Adult↗

What can we learn from the phenomenon of preferential lymph node metastasis in carcinoma?

Lymph nodes are the most common and earliest site of malignancies arising in epithelia. However, the reason for this pattern of preferential metastasis is not clear. This article reviews features of the metastatic process and lymph node microenvironment which might potentiate lymph node metastases. There is intriguing evidence that preferential lymph node metastasis is due to (1) the efficiency of lymph nodes as filters of the tumor cells which arrive there, and (2) the probability that adhesive interactions, normally governing the generation of different T-cell immune responses, are responsible for this efficiency and may also promote invasion and proliferation of tumor cells in the lymph node. Manipulation of the cytokine environment in a lymph node draining a primary epithelial tumor may alter both the expression of cell adhesion molecules within the node and the subsequent metastatic ability of the tumor cells arriving at it.

Carcinoma↗

Expression of p57kip2, Rb protein and PCNA and their relationships with clinicopathology in human pancreatic cancer.

AIM: To investigate the effects of inhibiting factor of cell cycle regulation p57(kip2), retinoblastinoma protein (Rb protein) and proliferating cell nuclear antigen (PCNA) in the genesis and progression of human pancreatic cancer. METHODS: The expression of p57(kip2), Rb protein and PCNA in tumor tissues and adjacent tissues of 32 patients with pancreatic cancer was detected with SP immunohistochemical technique. RESULTS: p57(kip2) protein positive-expression rate in tumor tissues of pancreatic cancer was 46.9 %, which was lower than that in adjacent pancreatic tissues (75.0 %) (chi(2)=5.317, P<0.05), p57(kip2) protein positive-expression correlated significantly with tumor cell differentiation (well-differentiation versus moderate or low-differentiation, P<0.05) but did not correlate significantly with lymph node metastasis (lymph node metastasis versus non-lymph node metastasis, P>0.05); Rb gene protein positive-expression rate in tumor tissues was 50.0 %, which was also lower than that in adjacent pancreatic tissues (78.1 %) (chi(2)=5.497, P<0.05); PCNA positive-expression rate was 71.9 %, being higher than that in adjacent pancreatic tissues (43.8 %) (chi(2)=5.189, P<0.05), PCNA positive-expression also correlated significantly with tumor cell differentiation and lymph node metastasis (well-differentiation versus moderate or low- differentiation, lymph node metastasis versus non-lymph node metastasis, P<0.05). Rb protein positive-expression rate in the tumor tissues of p57(kip2) protein positive-expression group was 53.3 %; and Rb protein positive-expression rate in the tumor tissues of p57(kip2) protein negative-expression group was 47.1 %. There was no significant relationship between the two groups (r=0.16507, P>0.05). CONCLUSION: The decreased expression of p57(kip2), Rb protein or over-expression of PCNA protein might contribute to the genesis or progression of pancreatic cancer, p57(kip2), Rb protein and PCNA may play an important role in genesis and progression of pancreatic cancer.

Adult↗

[Papillary thyroid microcarcinoma presenting as cervical lymph node metastasis. Interest of tetrofosmin scintigraphy and lymph node thyroglobulin measurement].

PURPOSE OF THE STUDY: Thyroid microcarcinoma presenting as cervical lymph node metastasis is common and it is associated in most cases with the papillary variety. Diagnosis of lymph node metastases from a thyroid microcarcinoma is not always easy, because a thyroid nodule may not be palpable. MATERIAL AND METHOD: In this work, the authors report two cases of papillary microcarcinoma presenting as cervical lymph adenopathy. RESULTS: The diagnosis was made preoperatively by Tetrofosmin scintigraphy and thyroglobulin measurement in the lymph node. CONCLUSION: Tetrofosmine scintigraphy is a performing exam but with a poor specificity. Lymph node thyroglobulin is a simple exam which is very sensitive and specific.

Adult↗

Risk factors for lymph node metastasis from intramucosal gastric carcinoma.

BACKGROUND: Although regional lymph node metastasis from intramucosal early gastric carcinoma (EGC) is rare, it is very important to clarify the characteristics of patients having lymph nodal metastases in order to determine appropriate therapy. METHODS: The authors investigated 1196 patients with solitary intramucosal EGC who underwent resection at the National Cancer Center Hospital in Tokyo, with special reference to lymph node metastases. Eight clinicopathologic factors (age, sex, tumor: size, location, macroscopic type, histologic type, histologic ulceration of the tumor, and lymphatic vessel invasion) were investigated by univariate and multivariate analyses for their possible relationship to lymph node metastasis. RESULTS: Lymph node metastases were found in 43 patients (3.5%). Univariate analysis revealed that younger age (< 57 years), macroscopic depressed type, larger tumor size (> or= 30 mm), undifferentiated histologic type, histologic ulceration of the carcinoma, and lymphatic vessel invasion had a significant association with regional lymph node metastasis. Multivariate analysis revealed that lymphatic vessel invasion, histologic ulceration of the tumor, and larger size (> or = 30 mm) were independent risk factors for regional lymph node metastasis. The incidence of lymph node metastasis from intramucosal EGC negative for these 3 risk factors was only 0.36% (1 in 277 patients). CONCLUSIONS: Lymphadenectomy is unnecessary for patients with small intramucosal EGC with neither histologic ulceration of the tumor nor lymphatic vessel invasion because the incidence of regional lymph node metastasis is extremely low in those patients. The therapeutic options for such patients would be local resection or endoscopic resection.

Age Factors↗

Establishment of an oral squamous cell carcinoma cell line with high invasive and p27 degradation activities from a lymph node metastasis.

The extent of lymph node metastasis is a major determinant in the prognosis of oral squamous cell carcinoma (OSCC). We present here a new OSCC cell line, MSCC-1, established from a lymph node metastasis of a patient with OSCC of gingiva. First, we examined the expression of p27, p53 and Ki-67 in non-neoplastic mucosa, primary and metastatic cancer lesions by immunohistochemistry. Metastatic cancer cells in the lymph node showed the reduced expression of p27 in comparison with cancer cells in the primary lesion. Cancer celLs both in the primary and metastatic lesions showed overexpression of p53 and Ki-67. Overexpression of p53 and reduced expression of p27 in MSCC-1 cells were also determined by western blot analysis. To characterize MSCC-1 cells, furthermore, we examined the invasive activity and cell proliferation of MSCC-1, comparing with those of other OSCC cell lines, HSC-2 and HSC-3 cells. The invasive capacity of MSCC-1 cells was significant higher than HSC-2 and HSC-3 cells, but cell growth of MSCC-1 cells was slower than HSC-2 and HSC-3 cells. Moreover, we examined the p27 degradation activity by in vitro degradation assay. Interestingly, MSCC-1 cells have the strongest p27 degradation activity among the OSCC cell lines examined. In the present study, we newly established MSCC-1 cells with strong invasiveness and p27 degradation activity from a metastatic lesion. These findings suggest that high activity of p27 degradation may concern with invasiveness of OSCC cells and that MSCC-1 cells can be a useful cell model for studying the detailed mechanism of p27 degradation, invasion and metastasis of OSCC.

Blotting, Western↗

Two cases of gastric involvement of esophageal cancer: intramural metastasis and intramural lymph node metastasis.

Cases of esophageal cancer with intramural metastasis to the stomach and esophageal cancer with metastasis to an intramural lymph node of the stomach are herein reported. The former patient was a 52 year-old male. Squamous cell carcinoma (SCC) of the lower esophagus with an intramural metastasis located at the gastric cardia and a small leiomyoma at the fornix were resected. The latter patient was a 70 year-old female. SCC of the lower esophagus and an intramural lymph node metastasis located at the anterior wall of the gastric cardia were resected. The patient died nevertheless of multiple liver metastases. These gastric involvements were detectable by endoscopy before surgery. The clinicopathological features of these esophageal cancers were characterized; the sites were the lower part of the esophagus, and extreme lymphatic and vascular invasions were shown histologically. The gastric tumors were located in the upper third of the stomach, and the findings revealed submucosal tumors. It is therefore important to discriminate other gastric tumors, and to resect them simultaneously with esophageal cancer when a gastric tube has been used for reconstruction after esophagectomy.

Aged↗

Tumor-secreted vascular endothelial growth factor-C is necessary for prostate cancer lymphangiogenesis, but lymphangiogenesis is unnecessary for lymph node metastasis.

Dissemination to draining lymph nodes is a frequent first step in prostate cancer metastasis. Although tumors metastasize to lymph nodes via the lymphatics, the importance of lymphangiogenesis in mediating the process remains controversial. Here, we inhibit intratumoral lymphangiogenesis in s.c. and surgical orthotopic implantation mouse models of human prostate cancer using several strategies. Stable expression of small interfering RNAs (siRNA) targeted against human vascular endothelial growth factor-C (VEGF-C) in PC-3 cells reduced intratumoral lymphatics by 99% in s.c. tumors, indicating that tumor-secreted VEGF-C is necessary for lymphangiogenesis. Expression of siRNAs against human VEGF-A somewhat reduced tumor lymphangiogenesis. Secretion of a soluble VEGF receptor-3/Flt4 fusion protein by PC-3 cells reduced intratumoral lymphatics by 100% in s.c. tumors. Combination of soluble Flt4 and VEGF-C siRNA yielded >92% reduction of intratumoral lymphatics in orthotopic prostate tumors. However, metastasis to lymph nodes was not significantly affected regardless of intratumoral lymphatic vessel density. The abundance of marginal lymphatics at the tumor-stromal interface was unchanged in orthotopic tumors whose intratumoral lymphatics were inhibited, suggesting that these marginal vessels could be sufficient for lymph node metastasis. Hematogenous metastasis (blood tumor burden, lung metastasis) correlated with degree of lymph node invasion. We also analyzed the lymphatics in spontaneous transgenic adenocarcinomas of the mouse prostate which metastasize to lymph nodes. Progression from well-differentiated prostate intraepithelial neoplasia to metastatic, undifferentiated adenocarcinoma was accompanied by loss of lymphatics. These results suggest that tumor-secreted VEGF-C and, to a lesser extent, VEGF-A, are important for inducing prostate cancer intratumoral lymphangiogenesis but are unnecessary for lymph node metastasis.

Adenocarcinoma↗

[Expression of VEGF-C and angiogenesis, and lymphangiogenesis in papillary thyroid carcinoma].

OBJECTIVE: To investigate the relationship between the expression of vascular endothelial growth factor C (VEGF-C) and angiogenesis and lymphangiogenesis in papillary thyroid carcinoma (PTC). METHODS: Seventy-two PTC cases were divided into 3 groups according to the level of invasion: papillary microcarcinoma group (PMC group), intrathyroid carcinoma group (IPC group), and extrathyroid carcinoma group (EPC group). They were again divided into 2 groups according to lymph node metastasis: lymph node metastasis group and lymph node no-metastasis group. The expressions of VEGF-C, CD105 and vascular endothelial growth factor receptor-3 (VEGFR-3) were detected by SP method of immunohistochemical staining. The expression of VEGF-C was analyzed quantitatively by image analysis system, and the PI of VEGF-C (VEGF-C-PI), the number of MVD (microvessel density), and LVD (lymphaticvessel density) were obtained. RESULTS: The VEGF-C-PI of lymph node metastasis group (23.15 +/- 3.75) was higher than that of lymph node non-metastasis group (14.54 +/- 2.93) (P <0.01). MVD was 35.25 +/- 2.06 in the PMC group, 41.75 +/- 5.46 in the IPC group, and 52.58 +/- 4.16 in the EPC group, which showed the elevatory tendency with the increase of invasion (P < 00.5). LVD was 6.00 +/- 0.81 in the PMC group, 13.80 +/- 1.81 in the IPC group, and 19.17 +/- 2.96 in the EPC group, which again showed the elevatory tendency with the increase of invasion (P <0.05). The LVD of lymph node metastasis group (19.56 +/- 2.45) was significantly higher than that of lymph node non-metastasis group (12.48 +/- 2.84) (P < 0.05). VEGF-C was positively correlated with MVD and LVD (r = 0.743, 0.90, P <0.01). CONCLUSION: The expressions of VEGF-C and LVD are related to lymph node metastasis of PTC. MVD and LVD are related to the invasion of PTC. VEGF-C may play an important role in the angiogenesis and lymphangiogenesis.

Adenocarcinoma, Papillary↗

Genomic copy-number aberrations related to lymph-node metastasis of colon cancer.

Lymph-node metastasis is an important indicator in the diagnosis of colon cancer. In order to determine the genes involved in metastasis, genomic copy-number aberrations in the primary tumours and lymph-node metastases were analysed in 12 patients using comparative genomic hybridization. This method detects genomic copy-number changes at the chromosomal level and the identification of the regions of aberration on any chromosome. Copy-number gains at 6p12 and losses at 8p12 were observed in a greater number of the primary tumours than in the metastases. These aberrations appear to be involved in lymph-node metastasis of colon cancer, and may allow measurement of the risk of lymph-node metastasis from a given colon cancer.

Adenocarcinoma↗

In vitro B-mode ultrasonographic criteria for diagnosing axillary lymph node metastasis of breast cancer.

Axillary lymph node status is an important factor for staging and treatment planning in breast cancer. Our study was performed in vitro on a node-by-node basis to evaluate the ability of B-mode ultrasonographic images to distinguish metastatic from nonmetastatic nodes. Immediately prior to histologic examination, individual dissected axillary nodes were scanned in a water bath using a 10 MHz B-mode ultrasonographic transducer. Four B-mode features (size, circularity, border demarcation, and internal echo) were evaluated for their ability to distinguish metastatic from nonmetastatic lymph nodes. Lymph node metastasis was indicated by (1) a large size (i.e., a length of the longest axis of 10 mm or greater); (2) a circular shape (i.e., the ratio of the shortest axis to the longest axis between 0.5 and 1.0); (3) a sharply demarcated border compared with surrounding fatty tissue; and (4) a hypoechoic internal echo, with obliteration of the fatty hilum. The sensitivity and specificity were compared for all combinations of features. We examined 84 histologically characterized axillary nodes from 27 breast cancer patients, including 64 nonmetastatic and 20 metastatic nodes. Of the criteria cited, circular shape was the best single feature for distinguishing metastatic from nonmetastatic nodes (sensitivity, 65%; specificity, 73%). The best combination of sensitivity (85%) and specificity (73%) was obtained using the criterion that a lymph node contained cancer when at least three positive features were present. The present in vitro study demonstrated that the sensitivity and specificity of B-mode ultrasonography for diagnosing lymph node metastasis were lower than 90%. Therefore, B-mode ultrasonography may not be an optimal noninvasive screening method for diagnosing axillary lymph node metastasis in breast cancer patients, particularly under in vivo clinical conditions.

Adult↗

Prediction of supraclavicular lymph node metastasis in breast carcinoma.

PURPOSE: Supraclavicular lymph node metastasis in breast cancer patients has a poor prognosis, and aggressive local treatment has usually resulted in severe morbidity. The purpose of this study was to select high-risk neck metastasis patients for prophylactic radiotherapy. METHODS: Between 1990 and 1998, 2658 consecutive invasive breast cancer patients underwent surgery and adjuvant therapy in the hospital. The median age was 47 years (range 22-92). The median follow-up period was 39 months. The following factors were analyzed: age, tumor size, tumor location, histologic type, histologic grade, estrogen and progesterone receptor status, DNA flow cytometry study results, number of positive axillary lymph nodes, use of chemotherapy, radiotherapy, and/or hormonal therapy, and level of involved axillary nodes. RESULTS: Of the 2658 patients, 113 (4.3%) developed supraclavicular lymph node metastasis during this period. Young age (< or =40 years), tumor size >3 cm, high histologic grade, angiolymphatic invasion, negative estrogen receptor status, synthetic phase fraction >4%, >4 positive nodes, and level II or III involved nodes were all significant for predicting neck metastasis in the univariate analysis. Three predictive factors were significant after multivariate analysis: high histologic grade, >4 positive nodes, and axillary level II or III involved nodes. In patients with axillary level I involved nodes and < or =4 positive nodes, the incidence was 4.4%. If axillary level III was involved, the rate of supraclavicular lymph node metastasis was 15.1%. CONCLUSION: The incidence of supraclavicular lymph node metastasis was higher in the groups with >4 positive nodes and in those with axillary level II or III involved nodes. Selective use of comprehensive radiotherapy for these high-risk patients will achieve good locoregional control.

Adult↗

Expression of vascular endothelial growth factor D is associated with lymph node metastasis in human colorectal carcinoma.

OBJECTIVE: Expression of vascular endothelial growth factor (VEGF)-D by tumors is associated with metastasis to lymph nodes in mice. However, there are few reports concerning the clinical significance of VEGF-D protein in human carcinoma. METHODS: After confirming production of VEGF-D by eight colorectal carcinoma cell lines, we investigated relationships between the expression of VEGF-D protein, lymph node metastasis and postoperative survival in 83 colorectal carcinoma patients. mRNA levels in cell lines were evaluated using the real-time reverse transcriptase-polymerase chain reaction, and protein was detected by Western blotting in cell lines and by immunohistochemistry in resected tissues using an antibody recognizing the processed form of the molecule. RESULTS: Immunohistochemistry showed VEGF-D-positive staining in 26 of the 83 carcinomas (31%). There was a significant relationship between the presence of VEGF-D protein and the incidence of lymph node metastasis (p < 0.01). Multivariate logistic regression analysis revealed that VEGF-D protein expression was an independent factor affecting lymph node metastasis (p < 0.01). Nonetheless, the presence or absence of VEGF-D protein had no significant impact on the survival of the patients (p = 0.15). CONCLUSION: These results suggest that the expression of VEGF-D protein could be useful in predicting the nodal status of colorectal carcinoma patients.

Adult↗

Overexpression of CCR7 mRNA in nonsmall cell lung cancer: correlation with lymph node metastasis.

Tumor cell migration into the lymph nodes is an important aspect of cancer, yet little is known about the processes involved. CCR7 has been shown to play an important role in tumor cell migration and lymph node metastasis. The aim of our study was to evaluate the expression of CCR7 in nonsmall cell lung cancers (NSCLCs). We investigated CCR7 expression in 71 patients with NSCLC who underwent curative tumor resection by means of reverse transcription-polymerase chain reaction (RT-PCR) and immunohistochemistry. CCR7 mRNA was expressed in 45 cases (63.3%). The CCR7 mRNA expression was significantly associated with lymph node metastasis, stage, lymphatic invasion, CCR7 protein and CXCR4 protein (p = 0.0001 for lymph node metastasis; p < 0.0001 for stage; p = 0.0454 for lymphatic invasion; p < 0.0001 for CCR7 protein; p = 0.0013 for CXCR4 protein). Twenty-six (57.8%) of 45 cases with CCR7 mRNA expression in their cancer tissues were node-positive, whereas only 3 (11.5%) of 26 cases without CCR7 mRNA expression were node-positive. Furthermore, expression of CCR7 mRNA was shown to be an independent predictor of lymph node metastasis by multivariate analysis (p = 0.0117). Our study demonstrates that CCR7 might be related to the development of lymph node metastasis in NSCLC. The expression of CCR7 mRNA could open up a new window for the diagnostic staging and treatment of NSCLC.

Aged↗