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PubMedDate not supplied

Tumor markers and lymphatic metastasis in head and neck cancer patients.

OBJECTIVE: This study was conducted to evaluate the relationship between the lymph node status and tumor marker status in patients with histologically confirmed head and neck cancer. MATERIALS AND METHODS: 134 patients were included in this retrospective analysis. 33/134 were classified as NO and 101/134 as N+. The wall of the lymph node was ruptured by the metastasis in 70/134 patients (poor prognosis). We analyzed the sensitivity of squamous cell carcinoma antigen (SCC), carcinoembryotic antigen (CEA) and CYFRA 21-1 in the total population and in the subgroups. RESULTS: We observed elevated SCC levels in 21.6%, CEA levels in 23.9% and CYFRA 21-1 levels in 50.0% of all patients. If there was no lymphatic metastasis, the SCC sensitivity was 15.1%, the CEA sensitivity was 21.2% and the CYFRA 21-1 sensitivity was 36.4%. Lymph node-positive disease had increased SCC levels in 23.8% of the patients, increased CEA levels in 24.8% and increased CYFRA 21-1 levels in 54.5%. The subgroup of patients with ruptured lymph nodes had the following sensitivities: SCC 18.6% CEA 8.6%, and CYFRA 21-1 50.0%. CONCLUSION: No significant relationship between the lymph node metastasis and the elevation of tumor markers in patients with advanced head and neck cancer was found.

Aged↗
PubMed2005

The pattern of lymphatic metastasis of breast cancer and its influence on the delineation of radiation fields.

PURPOSE: The delineation of radiation fields should cover the clinical target volume (CTV) and minimally irradiate the surrounding normal tissues and organs. This study was designed to explore the pattern of lymphatic metastasis of breast cancer and indications for radiotherapy after radical or modified radical mastectomy and to discuss the rational delineation of radiation fields. METHODS AND MATERIALS: Between September 1980 and December 2003, 78 breast cancer patients receiving extended radical mastectomy in the Margottini model and 61 cases with complete data were analyzed to investigate the internal mammary lymphatic metastatic status. Between March 1988 and December 1988, 46 patients with clinical negative supraclavicular nodes received radical mastectomy plus supraclavicular lymph node dissection. The supraclavicular lymph nodes and axillary lymph nodes were labeled as S and levels I, II, or III, respectively, and examined pathologically. Between January 1996 and April 1999, 412 patients who had radical or modified radical mastectomy underwent the pathologic examination of axillary or levels I, II, or III nodes. RESULTS: The incidence of internal mammary lymph node metastasis was 24.6%. It was 36.7% for the patients with positive axillary lymph nodes and 12.9% for the patients with negative axillary lymph nodes. All the metastatic internal mammary lymph nodes were located at the first, second, and third intercostal spaces. Skipping metastasis of the supraclavicular and axillary lymph nodes was observed in 3.8% and 8.1% of patients, respectively. CONCLUSIONS: According to our data, we suggest that the radiation field for internal mammary lymph nodes should exclude the fourth and fifth intercostal spaces, which may help to reduce the radiation damage to heart. It is unnecessary to irradiate the supraclavicular lymph nodes for the patients with negative axillary level III nodes, even with positive level I and level II nodes.

Adenocarcinoma↗
PubMed2007

Tissue factor expression is a clinical indicator of lymphatic metastasis and poor prognosis in gastric cancer with intestinal phenotype.

BACKGROUND AND OBJECTIVES: Tissue factor (TF), which normally safeguards vascular integrity by inducing hemostasis upon injury, has received widespread attention in the pathogenesis of cancer progression and metastasis. Aberrantly expressed TF in cancer cells has been reported to be associated with advanced stages of malignancy in various cancers. METHODS: The expression of TF and microvessel density (MVD) were immunohistochemically evaluated in 207 gastric cancers, and their relationship with clinicopathological features was examined. RESULTS: TF was preferentially expressed (41.8%) in intestinal-type cancer at a significantly higher rate than that in diffuse-type cancer (12.1%, P<0.0001). The expression of TF was associated with advanced stage of disease and showed a positive correlation with a higher rate of lymphatic and venous invasion and lymphatic metastasis in intestinal-type, but not in diffuse-type carcinoma. Moreover, TF expression was associated with high MVD in the tumor and a worse outcome only in intestinal-type carcinoma. CONCLUSIONS: TF may be critically involved in tumor progression in intestinal-type, but not in diffuse-type, gastric carcinoma. The difference in clinical features between these two histological types might be partially dependent on TF expression profile.

Adenocarcinoma↗
PubMed2005

Correlation of hypoxia inducible factor-1alpha with lymphatic metastasis via vascular endothelial growth factor-C in human esophageal cancer.

Hypoxia inducible factor (HIF)-1alpha is a transcription factor that regulates the transcription of genes associated with cell proliferation and vascular development. In various cancer tissues, HIF-1alpha is associated with clinicopathological factors, such as the tumor size, histological grade, and lymph node status. Although HIF-1alpha plays a critical role in tumor growth by inducing vascular endothelial growth factor (VEGF), it is unclarified whether HIF-1alpha affects lymphatic metastasis. The purpose of this study is to clarify the correlation of HIF-1alpha protein expression with lymph node metastasis in esophageal squamous cell carcinoma (ESCC). The expressions of HIF-1alpha and VEGF-C, which is one of the main lymphangiogenic factors, were examined in five ESCC cell lines and 48 surgical specimens of ESCC. HIF-1alpha and VEGF-C mRNAs were expressed in all the five ESCC cell lines as determined by RT-PCR analysis. Immunohistochemically, 34 of the 48 patients (70.8%) were positive for HIF-1alpha and 29 patients (60.4%) were positive for VEGF-C. Clinicopathologically, HIF-1alpha expression correlated with lymphatic invasion and VEGF-C expression (P = 0.003 and P = 0.01, respectively). Furthermore, HIF-1alpha expression tended to correlate with lymph node metastasis (P = 0.09). These findings suggest that HIF-1alpha plays a role in lymphatic invasion and lymph node metastasis through the induction of VEGF-C in ESCC.

Biomarkers, Tumor↗
PubMed1999

The expression of variant exon v7-v8 CD44 antigen in relation to lymphatic metastasis of human breast cancer.

The purpose of this prospective study was to evaluate the expression of CD44 splice variant epitopes in human breast cancer and their potential as prognostic indicators. Invasive breast cancer tissues obtained from 91 patients were examined for expression of the standard CD44 antigen and variant CD44 antigens (v5, v6, v7, v7-v8, and v8-v10) by immunohistochemical staining to investigate the relations of these antigens to clinicopathological factors and prognosis. The expression of standard CD44 antigen was detected in 54.9% of 91 patients with primary human breast cancer. The variant epitopes of CD44 examined, i.e., v5, v6, v7, v7-v8, and v8-v10, were expressed in 54.9%, 54.9%, 0%, 34.1%, and 0%, respectively. There was a significant difference in tumor size, lymph nodal status, and degree of lymphatic permeation between patients who were positive for exon v7-v8 and those negative for this variant (p < 0.01). Prognosis was also significantly worse in patients positive for CD44 v7-v8 than in those negative for this variant. However, multivariate analysis with the three prognostic indicators tumor size, lymph nodal status, and the degree of lymphatic invasion, has shown that the expression of CD44 v7-v8 antigen in breast carcinoma was not a significant independent prognostic factor and was closely dependent on lymphatic invasion and nodal status. Fourteen of 31 patients who were positive for CD44 v7-v8 experienced recurrences. The mode of recurrence was lymphatic metastasis in 10 out of these 14 patients. Breast cancer cells expressing v7-v8 CD44 antigen have an extremely high affinity for lymph nodes and lymphatic vessels, and are likely to metastasize to distant lymph nodes even at a very early stage in the progression of this disease. This suggests that not only the anatomical factors but also organ affinity plays an important role in the establishment of lymph nodal metastasis of breast cancer.

Adult↗
PubMedDate not supplied

The pattern and timing of lymphatic metastasis of the rat carcinoma LMC.

The distribution pattern and latency of lymphatic metastases naturally disseminated by the Leeds Mammary Carcinoma (LMC1) when transplanted subcutaneously in isogeneic Johns' Strain Wistar rats has been determined. After the curative local irradiation and excision of the primary tumour in 210 rats, 55 +/- 3 per cent developed either local (26 +/- 3 per cent), and/or regional (28 +/- 3 per cent) and/or distant (37 +/- 3 per cent) lymph node metastases. Analysis of their pattern of distribution suggests that metastasis to local (inguinal and lumbar) and distant (axillary and mediastinal) nodes results mainly from the radial dissemination, trapping and nodal proliferation of cells released by the primary tumour. Although direct metastasis to the para-aortic node may have occurred, in the main seeding of this site and thence to other, regional, i.e. iliac and/or adrenal nodes, resulted from the dissemination of tumour cells from the local nodes. The latency of metastases appearing at different sites after primary tumour ablation, although highly variable, was site dependent and for local, regional and distant nodes was 30 +/- 14, 48 +/- 16, 56 +/- 17 days respectively. In addition, the latency of metastases at regional and distant nodes was directly correlated with the latency of local metastases. The latency of adrenal and iliac metastases also correlated with para-aortic node metastasis, as did mediastinal with axillary lymph node metastasis. From the data, a semi-quantitative model of lymphatic metastasis has been developed for further evaluation and adjuvant chemotherapy testing.

Adrenal Glands↗
PubMed1999

Lymphatic metastasis from tumors transplanted into the pre-irradiated footpad of the rat.

BACKGROUND: In the literature there is some evidence that the incidence of metastases may increase after radiation treatment. METHODS: In order to investigate whether radiation-induced changes in the lymphatic drainage may alter the rate of lymph node metastasis, the center part of the left hind foot of rats was irradiated with a dose of 1 x 55 Gy before inoculation of tumor cells into the irradiated part of the footpad at different time intervals. Cells of 2 different tumor lines were employed. A rarely metastasising rhabdomyosarcoma, R-1, to look for a possible enhancement of lymphatic metastases, and a readily metastasising mammary carcinoma, Cl-2, in case of a possible decrease in the rate of lymphatic metastasis from tumors growing in pre-irradiated footpads. RESULTS: The incidence of regional lymph node metastasis decreased for R-1 tumors growing in pre-irradiated footpads, but not for Cl-2 tumors. Furthermore, the average time required for lymph node metastasis to attain a reference volume of 100 mm3 is not significantly influenced by pre-irradiation of the footpad. No difference was observed in average times for doubling in volume of lymph node metastases originating from primary tumors in pre-irradiated footpads. Abscopal effects after footpad irradiation may cause a 50-fold increase in size of regional lymph nodes and, therefore, histological examination is essential for verification of lymph node metastases. CONCLUSIONS: Damage to the lymphatic system to be expected in the irradiated footpad did not enhance the incidence of regional metastasis of R-1 tumors. A reduced rate of lymphatic metastasis contradicts earlier findings of enhanced lymphatic metastasis development of R-1 tumors, growing in pre-irradiated gastrocnemius muscles. The influence of irradiation on regional metastasis formation seems to be "tumor bed" dependent for R-1 tumors.

Animals↗
PubMedDate not supplied

Lymphatic metastasis; lymphangiochemotherapy of mammary cancer: ascitic form of rat mammary adenocarcinoma 13762.

When 5 million cells of the ascitic form of the RMT 13762 are injected into syngeneic F344 rat footpads there is consistent metastasis to the popliteal node more rapidly than when the solid form is used. A greater number of tumor cells escapes from the footpad to the draining node via the afferent lymph than with the solid tumor. Local intralymphatic injection of 5FU produces cure or retardation of nodal metastasis in a significant number of animals (p less than 0.002).

Adenocarcinoma↗