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Results for “lymph node metastasis”

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PubMed2000

Assessment of cervical lymph node metastasis in the staging of thoracic esophageal carcinoma.

BACKGROUND: Cervical lymph node metastases (CLM) from esophageal carcinoma are regarded as a part of the M component of the TNM classification. Patients with CLM, however, can experience extended survival after cervical lymph node dissection, unlike patients with other M components. METHODS: Among 844 patients with thoracic esophageal carcinoma, 197 underwent esophagectomy with three-field dissection of the cervical, mediastinal, and abdominal lymph nodes (3FD). The survival of patients with CLM was compared with that of patients with hematogenous metastasis (HM), and the prognostic value of CLM was assessed. RESULTS: The survival curve for patients with CLM was significantly better than that for patients with HM (P = 0. 002). Among the 197 patients who underwent 3FD, 46 (23.4%) had histologic CLM. Of the 165 patients without hematogenous metastases, 22 (13.3%) had histologic CLM. The survival curve for the patients with histologic CLM was not significantly differ from that for patients with mediastinal or abdominal lymph node metastasis (P = 0. 127, P = 0.155) by univariate analyses. CONCLUSIONS: The significantly better survival of patients with CLM compared with that of patients with HM strongly suggests that CLM carries a prognosis different from the other M components in the staging of thoracic esophageal carcinoma. Because the survival curve for patients after 3FD was similar to that of patients with metastasis in the mediastinum or abdomen, we feel CLM should be included in the N component.

Adult↗

PubMed2006

[Mediastinal lymph node metastasis of thyroid cancer occurring 15 years after the initial operation; report of a case].

A 71-year-old woman was found to have an abnormal shadow on a chest X-ray. Fifteen years earlier she had undergone a subtotal thyroidectomy for thyroid cancer without any lymph node metastasis. Chest computed tomography (CT) revealed a mediastinal tumor with full of blood stream. Since the positron emission tomography (PET) disclosed an increased uptake of fluoro-2-deoxy-D-glucose (FDG) in the tumor, a malignant lymphatic tumor was therefore suspected. An immunohistological examination of biopsy specimens taken by thoracoscopic procedure demonstrated tumor to be lymph node metastasis of the previous thyroid cancer. After a tumor resection by means of a thoracotomy and total thyroidectomy, the patient was scheduled to receive radioiodine therapy. The previously reported cases are also herein reviewed.

Aged↗

PubMed1998

Vascular invasion of O-1N, hamster squamous cell carcinoma with high potential of lymph node metastasis: ultrastructural comparison between lymphatics and blood vessels.

The ultrastructural modes of lymphatic and blood vessel invasions were studied comparatively in hamsters with squamous cell carcinoma (O-1N) that had a high potential for lymph node metastasis. The endothelial injury, which was caused by mechanical stretching with the growth of O-1N, was the initial and characteristic feature common to both vascular invasions. Tumor cell nests penetrating the lymphatic lumen through disrupted endothelial cells still maintained their volume and continuity to the underlying tumor cell nests. In contrast, pronounced microthrombotic and neutrophilic reactions occurred at the site of blood vessel penetration. Within the lymphatic lumen, large clusters of O-1N cells were kept longer in spite of lymphocytic and macrophagic reactions. In blood vessels, clusters of tumor cells that had passed through dense fibrin layers were reduced in size and further disintegrated into smaller pieces by neutrophils. In conclusion, lymphatic invasion is a mechanical process, and smooth and direct invasion of large tumor cell nests into lymphatic vessels is responsible for causing more prompt and frequent lymph node metastasis in O-1N than a hematogenous type.

Animals↗

PubMed1991

Results of postoperative radiotherapy for clinical stage Ib uterine cervical carcinoma with evidence of microscopic involvement of surgical margin, parametrium and/or lymph node metastasis.

From January 1979 to September 1985, a total of 125 patients preoperatively staged as International Federation of Gynecology and Obstetrics (FIGO) Ib uterine cervical carcinoma were proven to have either microscopic involvement of the surgical margin, parametrium and/or regional lymph node metastasis histopathologically after radical hysterectomy and pelvic lymphadenectomy. All of these patients were treated postoperatively with radiotherapy because of the above indications. Based on indications of postoperative radiotherapy, patients were divided into 3 major subgroups according to the microscopic involvement: group A patients (50) with microscopic evidence of regional lymph node metastasis only; group B patients (59) with microscopic evidence of parametrial involvement; and group C patients (16) with microscopic infiltration of the surgical margin involving the vaginal cuff. All patients were treated with external irradiation using a Cobalt-60 teletherapy machine. The overall actuarial 5-year survival rate was 62% with a 77% 5-year survival rate for group A, a 50% rate for group B and a 75% rate for group C. Further analysis of the prognostic factors revealed that those with regional lymph node involvement of 4 or less had a better chance of survival than those with lymph node involvement of more than 4. Also those with poorly differentiated squamous cell carcinoma had a lower 5-year survival rate than those with moderately or well-differentiated squamous cell carcinoma. Univariate analysis revealed that hemoglobin values, age, and the time interval from surgery to radiotherapy were not significant prognostic factors.

Adenocarcinoma↗

PubMed2002

A long-term survivor of intrahepatic cholangiocarcinoma with lymph node metastasis: a case report.

We describe a case of intrahepatic cholangiocarcinoma (ICC) in a 50-year-old man. A well-defined, hypoechoic tumor, 3.5 cm in greatest diameter, was detected in the left medial segment of the liver with ultrasonography. Celiac angiography showed staining at the same location. Computed tomography revealed lymph node swelling around the head of the pancreas. On October 10, 1993, the patient underwent partial hepatectomy with pancreatoduodenectomy and lymph node dissection around the hepatoduodenal ligament and along the common hepatic artery. Postoperative histopathological examination showed a moderately differentiated tubular adenocarcinoma which had metastasized to the dissected lymph nodes at the posterior surface of the head of the pancreas and at the root of the middle colic artery. Eight years after surgery, the patient is alive and well with no sign of recurrence. Immunohistochemical staining showed ductal-type mucin core protein-1 expression in the tumor, which indicates more favorable survival after surgery. Patients with ICC and lymph node metastasis are considered to have poor prognosis; however, further study of the characteristics of ICC with lymph node metastasis is needed.

Bile Duct Neoplasms↗

PubMed1989

[Definition of the adaptation of endoscopic surgery for early gastric cancer. Special examination on the relationship between the histological differentiation of the intramucosal gastric cancer and the lymph node metastasis].

Out of five hundred and nineteen surgically resected lesions which were histologically shown to be intramucosal gastric cancer, 247 were well differentiated, 98 were moderately differentiated, and 176 were poorly differentiated lesions. The incidence of lymph node metastasis in the 247 well differentiated, 98 moderately differentiated, and 176 poorly differentiated intramucosal adenocarcinomas were 0.8% (= 2/247), 2.1% (= 2/98), and 8% (14/176), respectively. The cumulative survival rate of 5 years after gastrectomy was 94.2% for the 247 well, 93.3% for the 98 moderately, and 93.7% for the 176 poorly differentiated adenocarcinomas. A pathological study on the atypism of the gland of the cancer and the condition of the proprial space under the cancer cells was conducted on 100 lesions of well differentiated adenocarcinomas in order to define the criteria of non-surgical endoscopic removal resection for early gastric cancer. Out of the 100 lesions mentioned above, there were only two well differentiated adenocarcinomas with lymph node metastasis in which the boundary between the epithelium of the cancer and the proprial space under the cancer was very unclear and the interstitial space in the propria under the cancer was very small. On the other hand, we have resected 73 intramucosal gastric cancers using the endoscopic surgical method called strip biopsy since 1984, and have followed up these cases. The cancers resected by strip biopsy, and were histologically intramucosal well differentiated adenocarcinomas shown to have a moderately maintained interstitial space under the cancer cells. And, up to the present, there has been no incidence of recurrence after strip biopsy for the 73 lesions mentioned above. According to these results, we have defined the criterion for early gastric cancer endoscopic surgery, as follows. Intramucosal cancer which is shown to be well differentiated adenocarcinoma with a moderately maintained interstitial space under the cancer cells is considered to be sufficient for non-surgical endoscopic resection.

Aged↗

PubMed1980

Lymph node metastasis and effects of 1-beta-D-arabinofuranosylcytosine, 5-fluorouracil, and their lipophilic derivatives in an experimental model system using P388 leukemia.

Mouse P388 leukemic cells inoculated into the right forefootpad metastasized primarily to the right axillary lymph node. No significant metastasis to other lymph nodes or organs was detected on Day 12 after the inoculation of 10(6) P388 cells in the forefootpad, except that a lesser extent of metastasis was observed in some cases in the right inguinal lymph node, liver, and spleen. A quantitative estimation of metastasis in the axillary lymph node was accomplished by transferring the lymph node i.p. to the recipient mice (bioassay method). The metastasis of P388 cells to the axillary lymph node occurred linearly depending on the elapse of time after inoculation. In studying the chemotherapeutic effect on lymph node metastasis, two experimental models were established. Model 1, 10(6) P388 cells were inoculated into the right forefootpad, and drug was administered thereafter. The right axillary lymph node was removed on Day 8, and the extent of inhibition of lymph node metastasis was estimated by the bioassay method. In Model 2, P388 cells were inoculated, and the right forelimb including original tumor was amputated on Day 6 when the metastasis had already been established. The drug was given thereafter, and the extent of inhibition of metastasis was estimated on Day 12 by the bioassay method. In this experimental system, a lipophilic derivative N4-behenoyl-1-beta-D-arabinofuranosylcytosine was more effective than its parent compound 1-beta-D-arabinofuranosylcytosine; however, 5-fluorouracil was found to be more potent than its lipophilic derivative ftorafur for the inhibition of lymph node metastasis, suggesting an existence of various pharmacokinetic factors for the inhibition of lymph node metastasis.

Animals↗

PubMed1999

Significance of axillary lymph node metastasis in primary breast cancer.

PURPOSE: Axillary lymph node status is the single most important prognostic variable in the management of patients with primary breast cancer. Yet, it is not known whether metastasis to the axillary nodes is simply a time-dependent variable or also a marker for a more aggressive tumor phenotype. The purpose of this study was to determine whether nodal status at initial diagnosis predicts outcome after relapse and therefore also serves as a marker of breast cancer phenotype. PATIENTS AND METHODS: Survival experience after first relapse in 1,696 primary breast cancer cases was analyzed using Cox proportional hazards regression. The following explanatory variables and their first-order interactions were considered: number of axillary lymph nodes involved (zero v one to three v four or more), hormone receptor status (any estrogen receptor [ER] negativity v ER negativity/progesterone receptor positivity v other ER positivity), primary tumor size (< 2 cm v 2 to 5 cm v > 5 cm), site of relapse (locoregional v distant), disease-free interval (< 1.5 years v 1.5 to 3 years v > 3 years), adjuvant endocrine therapy (none v any), adjuvant chemotherapy (none v any), and menopausal status (pre-, peri-, or postmenopausal). RESULTS: Axillary lymph node status, site of relapse, and hormone receptor status were all highly significant as main effects in the model. After adjustment for other variables, disease-free interval alone was only modestly significant but interacted with nodal status. After disease-free interval, hormone receptor status, and site of relapse were accounted for, survival after relapse was poorer in node-positive cases, when compared with node-negative cases. The hazard ratios for patients with one to three and four or more involved nodes were 1.2 (95% confidence interval [CI], 0.8 to 1.9) and 2.5 (95% CI, 1.8 to 3.4), respectively. CONCLUSION: Patients with four or more involved nodes at initial diagnosis have a significantly worse outcome after relapse than node-negative cases, regardless of the duration of the disease-free interval. We conclude that nodal metastasis is not only a marker of diagnosis at a later point in the natural history of breast cancer but also a marker of an aggressive phenotype.

Axilla↗

PubMed1990

Risk factors for the development of lymph node metastasis in vulvar squamous cell carcinoma.

One hundred and ten women who underwent vulvectomy and inguinal-femoral lymphadenectomy for stages I-IV vulvar squamous cell carcinoma were studied. The most important factors that affected the inguinal lymph node status in the order of importance were vascular invasion, clinical stage, tumor thickness, depth of stromal invasion, and amount of keratin. Fourteen (88%) of 16 tumors with vascular invasion in the primary tumor metastasized. In the absence of vascular invasion, 18 (19%) of 94 tumors metastasized. Overall, 82% of tumors were correctly classified into lymph node negative and positive groups on the basis of vascular invasion. Tumor thickness and depth of stromal invasion had a similar accuracy in predicting lymph node status. The risk of lymph node metastasis increased from 0% when tumor thickness or depth of stromal invasion was less than 2 mm, to over 20% when depth of stromal invasion was greater than 2 mm, and to over 40% when tumor thickness exceeded 4 mm. A combination of vascular invasion, tumor thickness (or depth of stromal invasion), and the amount of keratin correctly classified 97% (76/78) of the lymph node negative group and 63% (20/32) of the positive group with an overall accuracy of 87%. The probability of having lymph node metastasis was computed for individual patients on the basis of one or more pathologic parameters using a logistic regression model. This feasibility is an important step toward individualized therapy for vulvar carcinoma.

Carcinoma, Squamous Cell↗

PubMed2026

Papillary Thyroid Carcinoma with Terminal Immune Exhaustion Phenotype Correlates with Increased Risk of Lymph Node Metastasis: An Exploratory Study Combining Flow Cytometry and TCGA.

BACKGROUND: Papillary thyroid carcinoma (PTC) is the most common thyroid malignancy, with lymph node metastasis (LNM) being a key predictor of recurrence and poor prognosis. Preoperative detection of LNM remains challenging due to the limitations of imaging modalities, leading to inadequate surgical resection in 20-30% of patients. While immune checkpoint molecules have been implicated in PTC progression, the heterogeneity of CD8+ T cell exhaustion subsets and their specific association with LNM remain poorly defined. In this study, we aimed to perform an exploratory characterization of the distinct immune landscape of PTC prone to LNM, with a focus on terminal immune exhaustion, in order to generate hypotheses for improved risk stratification and therapeutic strategies. METHODS: Fresh PTC tissues from 40 patients (22 LNM-positive and 18 LNM-negative) were analyzed via flow cytometry (FCM) to quantify immune cell subsets, inflammatory cytokines, and chemokines. Immunohistochemistry (IHC) validated CD45+ immune cell infiltration. Transcriptomic and clinical data from 448 PTC patients in The Cancer Genome Atlas (TCGA-PTC) cohort were used for bioinformatic analysis consistent with the observed phenotype, including Gene Set Variation Analysis (GSVA) of terminal exhaustion gene signatures. RESULTS: LNM-positive PTC exhibited a unique inflammatory milieu with significantly elevated IL-6, IL-1ra, CCL5, and IL-9 levels (all p < 0.05) in tumor interstitial fluid. FCM analysis revealed that LNM-positive PTC had increased infiltration of total CD45+ immune cells, CD3+ T cells, and CD3+CD8+ T cells (all p < 0.05). Critically, terminally exhausted PD-1hiTIM-3+ CD8+ T cells were significantly enriched in LNM-positive PTC (p = 0.022) and positively correlated with extrathyroidal extension (p = 0.044). Additionally, LNM risk was associated with increased CD4+ regulatory T (Treg) cell frequency (p = 0.023) and elevated CTLA-4 expression on CD4+ T cells (p = 0.047). In TCGA-PTC validation, the terminal exhaustion gene signature was predominantly enriched in LNM-positive (p < 0.0001) and advanced-stage PTC (p < 0.001) and strongly correlated with BRAF mutation (predominantly V600E) (p < 0.0001)-the most common oncogenic driver in aggressive PTC. CONCLUSIONS: Our findings suggest a terminal immune exhaustion phenotype (characterized by PD-1hiTIM-3+ CD8+ T cells and Treg enrichment) as a potential key feature associated with LNM-prone PTC. This phenotype shows consistency across clinical samples and TCGA datasets, linking BRAF mutation (predominantly V600E) to immune suppression and metastatic potential. These insights provide a novel exploratory immune-based biomarker for LNM risk stratification and support the potential of combining anti-PD-1/TIM-3 therapy with BRAF inhibitors for high-risk PTC, which should be confirmed in future studies.

lymph node metastasis↗

PubMed2000

Sensitive detection of mediastinal lymph node metastasis of lung cancer with 11C-choline PET.

UNLABELLED: 11C-choline and FDG are PET tracers used to visualize various malignancies. In this study, we compared their capabilities in detecting mediastinal lymph node metastasis originating from non-small cell lung cancer (NSCLC). METHODS: Twenty-nine patients with biopsy-proven NSCLC were studied with PET. 11C-choline PET and FDG PET were performed from 5 and 40 min, respectively, after injection of 370 MBq tracer. PET data were analyzed in terms of the standardized uptake value (SUV). After the PET study, the patients underwent lung resection and mediastinal lymph node dissection. The resected specimens were examined pathologically, and the PET data were analyzed in reference to the pathologic data. RESULTS: With 11C-choline, the SUV in metastasis was similar to the SUV in the primary tumor, where the similarity of the SUV was 100% allowing for a 40% difference. With FDG, small metastases were invisible on the PET image. The SUV of FDG in metastasis was much smaller than that in the primary tumor, and the similarity of the SUV was only 19% allowing for a 40% difference. When pathologic findings were used as standards, the sensitivities of 11C-choline PET and FDG PET in detecting mediastinal lymph node metastasis were 100% and 75%, respectively. CONCLUSION: 11C-choline PET was very effective in detecting lymph node metastases in the mediastinum originating from NSCLC, with a sensitivity of 100%. 11C-choline PET promises to be useful not only before surgery but also after surgery.

Adult↗

PubMed2000

Clinicopathological features and overexpression of matrix metalloproteinases in intramucosal gastric carcinoma with lymph node metastasis.

Endoscopic mucosal resection, which has been widely accepted for the treatment of intramucosal gastric carcinoma (IMGC) because of the minimal invasiveness of the procedure and the sustained quality of life it provides, can only be used on the premise that the carcinoma has no lymph node metastasis. We evaluated the clinicopathological and biological features of IMGC with lymph node metastases in relation to matrix metalloproteinase (MMP) expression. Fifteen cases of lymph node metastasis-positive [n(+)] IMGC and 59 cases of lymph node metastatic-negative [n(-)] IMGC were obtained. The expression of MMP-2 and MMP-9 was investigated with immunohistochemical methods. Clinicopathologically, n(+)-IMGCs were more likely to be of a larger size, to be of poorly differentiated adenocarcinoma, to have had lymphatic permeation [ly(+)], and to have ulcerations within the lesion compared to n(-)-IMGCs. The incidence of the positive expression of MMP-9 in n(+)-IMGCs (67%) or ly(+)-IMGCs (86%) was significantly higher than that in n(-)-IMGCs (32%) or ly(-)-IMGCs (34%). Even in IMGCs, carcinoma cells may produce MMPs that can degrade the basement membrane, allowing them to permeate the lymph capillary. Ulcerations within the lesion may also facilitate the interchange of lymphatic flow between the mucosa and the submucosa, promoting the development of lymph node metastases.

Carcinoma↗

PubMed1995

Early mucosal gastric cancer with lymph node metastasis.

From 1976 to 1992, a total of 358 cases of mucosal early gastric cancer (m-cancer) were treated by resection in the First Department of Surgery, Kurume University Hospital. Eight (2.2%) of these 358 cases of m-cancer were associated with lymph node metastasis. In these 358 cases, the mean diameter of the tumor was 2.75 cm, and the mean age was 59.6 years. In the 8 cases of m-cancer with positive lymph node metastasis (n(+)), the mean diameter was 5.2 cm and the mean age was 51.6 years. Seven (87.5%) out of the 8 cases of m-cancer with n(+) were IIc macroscopic cancer type and were associated with ulcer and/or ulcer scar.

Adenocarcinoma↗

PubMed1998

Lymph node metastasis in patients with carcinomas of the renal pelvis and ureter.

OBJECTIVES: We evaluated the clinical significance of lymph node metastasis in patients with carcinomas of the renal pelvis and ureter. METHODS: 68 patients without distant metastasis were included in this study. Multivariate analysis by Cox's proportional hazards model was applied to detect the prognostic factor(s). RESULTS: 12 patients (17.6%) had nodal involvement. More than 10% of the patients with pT1-2 showed nodal metastasis. Preoperatively determined clinical factors were not a predictive factor for nodal involvement. Nodal metastasis was the only significant negative prognostic factor for patient survival by multivariate analysis. CONCLUSIONS: Lymph node dissection is valuable to predict the clinical outcome of the patients with carcinoma of the renal pelvis and ureter. Attention should be paid to nodal status to select patients for conservative surgery.

Adolescent↗

PubMed1997

[A case of scrotal cancer with inguinal lymph node metastasis treated by multidisciplinary modalities including chemotherapy with methotrexate, bleomycin and cisplatin].

We report a case of scrotum with inguinal lymph node metastasis which was successfully treated by multidisciplinary modalities including combination chemotherapy and radiotherapy. A 60-year-old man was admitted with ulcerative induration of the scrotum and inguinal lymph node swelling. Biopsy of the scrotal skin showed squamous cell carcinoma. He received 4 courses of combination chemotherapy with methotrexate, bleomycin and cisplatin. The primary lesion disappeared macroscopically and metastatic lymphadenopathy showed 50% reduction in size. Both lesions were further treated with radiotherapy (60 Gy). Because the primary lesion became ulcerative 7 months after irradiation, partial resection of the scrotum was performed. He has been free of recurrence 22 months after chemotherapy.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed1999

Heme oxygenase-1 expression in oral squamous cell carcinoma as involved in lymph node metastasis.

Thirty-eight oral squamous cell carcinomas (SCCs) were semi-quantitatively analyzed by immunohistochemical staining, and the relation between heme oxygenase-1 (HO-1) expression and the clinical status were correlated. High immunostaining of HO-1 was detected in lymph node metastasis negative groups (P = 0.0018) and in well-differentiated SCCs (P = 0.0016). There were no significant correlations between heme oxygenase-1 expression and other factors, such as size of the tumor, staging, age and sex. These findings further support the proposition that high heme oxygenase-1 expression in oral SCCs can be useful in identifying patients at low risk of lymph node metastasis.

Adult↗

PubMed1990

[Diagnosis of lymph node metastasis in esophageal carcinoma: detecting with coronal magnetic resonance imaging].

To assess the utility of MR imaging in diagnosis of lymph node metastasis, the author studied 70 patients with histologically proved esophageal squamous cell carcinoma. Coronal spin echo imaging (SE400/40) was the most available method in the mediastinum and using this method, lymph nodes were clearly imaged along trachea and vessels of the mediastinum in its long axis. The 250 lymph nodes from 44 patients who underwent laparotomy, thoracotomy and cervical dissection, were reviewed for findings by coronal MRI. Detectability of lymph nodes was 141/250 (56%) in total. Cervical and paraesophageal nodes were unable to detect well, but paratracheal, subcarinal, hilar nodes, supraclavicular nodes which are clinically important region for lymph node dissection of esophageal surgery were well-detected. Distinction between metastatic and non-metastatic nodes was studied on its size and its location. The supraclavicular and paratracheal nodes larger than 1.5 cm in diameter were involved in cancer invasion for the most part.

Carcinoma, Squamous Cell↗

PubMed2001

Overexpression of the G-protein inwardly rectifying potassium channel 1 (GIRK1) in primary breast carcinomas correlates with axillary lymph node metastasis.

The acquisition of genetic alterations in tumor cells is a hallmark of cancer progression. Genetic alterations, including chromosomal sequence alterations and abnormal gene expression, increase the malignant potential of tumors by affecting pathways that regulate cell growth, cell death, tumor angiogenesis, and invasion/metastasis. We used an expression profiling technique, representational difference analysis, to identify genes the expressions of which are aberrantly increased in invasive breast carcinomas as compared with adjacent normal breast tissue from the same individual. Among the genes we identified was GIRK1, which encodes a 501 amino acid, G-protein inwardly rectifying potassium channel protein. We then measured GIRK1 mRNA expression in benign breast tissues, primary invasive breast carcinomas, and metastatic breast carcinomas from axillary lymph nodes using quantitative TaqMan reverse transcription-PCR and correlated the results with clinical parameters. We found that GIRK1 overexpression correlated with lymph node metastasis (P < 0.0029), and overexpression was greatest in tumors with more than one positive lymph node. These results indicate that GIRK1 may be useful as a biomarker for lymph node metastasis and possibly a pharmaceutical target.

Adult↗