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PubMed1980

Eosinophilic granuloma of lymph nodes--a variant of histiocytosis X.

A clinicopathologic study of histiocytosis X in lymph nodes disclosed a special variant: primary eosinophilic granuloma of lymph nodes. This variant involves one or more lymph nodes, but does not infiltrate any other organs. Histologically, the infiltration of lymph nodes by histiocytosis X cells and eosinophils is similar to that seen in disseminated or metastatic histiocytosis X. Most cases of eosinophilic granuloma of lymph nodes are recognizable as primary, however, by the heavy infiltration of the surrounding tissue. The predominant proliferating cells are histiocytosis X cells ('Langerhans cells'), which contain Birbeck granules on electron microscopy and are lysozyme-negative. The disease was found in 30 patients among a total of 64 cases of histiocytosis X collected at the Lymph Node Registry in Kiel. Primary eosinophilic granuloma of lymph nodes occurs predominantly in children and young adults and shows a slight preponderance of males. Clinically, the patients present with mostly afebrile and sometimes painful lymphadenopathy, which is more often solitary (in the cervical or inguinal region) than widespread. The erythrocyte sedimentation rate and/or serum alpha 2-globulin level are elevated in many patients. There may also be an increase in the number of leucocytes, especially eosinophils, in the blood. The prognosis is favourable: the lymphadenopathy disappeared spontaneously in most patients and only one patient developed two recurrences. Thus, primary eosophilic granuloma of lymph nodes is interpreted as a benign lesion. It might be a special reaction of the T cell system.

Adolescent↗

PubMed1997

Does lateral lymph node dissection improve survival in rectal carcinoma? Examination of node metastases by the clearing method.

BACKGROUND: The treatment of rectal carcinoma by lateral lymph node dissection has risks and benefits. Therefore, we investigated the therapeutic efficacy of lateral lymph node dissection. STUDY DESIGN: We studied 198 patients with rectal carcinoma who underwent lateral lymph node dissection. Metastases to the lymph nodes were examined by the clearing method. The incidence of urinary and male sexual dysfunction was determined by measuring the residual urine volume and individual interview 1 year after operation. RESULTS: The rate of metastasis to lateral lymph nodes was 11.1 percent, and metastasis to the lateral lymph nodes occurred more frequently with lower rectal carcinoma classified as pT3 or pT4 in the TNM system. The rate of local recurrence was 12.5 percent and the 5-year survival rate after curative resection was 70.1 percent. The 5-year survival rate in patients with metastasis to the lateral lymph nodes was 25.1 percent, and this rate was significantly lower than the 5-year survival rate of 74.3 percent in patients without metastasis to the lateral lymph nodes. Urinary dysfunction was observed in 67.5 percent of patients, and male sexual dysfunction was found in 97.4 percent of men younger than 60 years of age with prior sexual ability. CONCLUSIONS: The prognosis for patients with metastasis to the lateral lymph nodes is poor, and the improvement in survival rate from lateral lymph node dissection is minimal.

Female↗

PubMed2006

Lymphoscintigraphy in detection of the regional lymph node involvement in gastric cancer.

INTRODUCTION: Involvement of regional lymph node is a critical sign in prognosis of gastric cancer. Radiological techniques are commonly used to evaluate the extension of gastric cancer. But their sensitivity and specificity are low especially in the early stage. Our aim was to assess the value of gastric lymphoscintigraphy in identifying regional lymph node involvement in patients with gastric cancer, as compared to the abdominal ultrasonography, computed tomography and postoperative histopathological evaluation. PATIENTS AND METHODS: 50 patients (12 females) with a median age of 61 years (range, 35-73 years) were included in the study. Pre-operative staging in all cases included upper gastrointestinal endoscopy and biopsy, followed by ultrasound, computed tomography and lymphoscintigraphy. 148 MBq Technetium-99m lymphoscint was injected around the tumour during endoscopy and immediately after injection, anterior, lateral and posterior images were taken in 5-min intervals using a gamma camera. Findings were compared to the findings of other tests. The sensitivity, specificity, positive predictive value, and negative predictive value of each test were calculated and compared. RESULTS: Histologically, 68% of cases (34/50) had metastasis in regional lymph nodes and all cases were accurately diagnosed by lymphoscintigraphy. Lymphoscintigraphy was significantly more sensitive for detecting lymph node involvement (P < 0.01). Both abdominal ultrasonography and CT had very low sensitivity in identifying lymph nodes. CONCLUSIONS: Lymphoscintigraphy is a promising test in the identification of regional lymph nodes pre-operatively in patients with gastric cancer. It might help the surgeon to plan the extent of dissection before surgery which may decrease postoperative complications related to unnecessary extensive lymph node dissection.

Adenocarcinoma↗

PubMed1999

Unique distribution patterns of metastatic lymph nodes in patients with superficial carcinoma of the thoracic oesophagus.

BACKGROUND: Lymph node metastasis is commonly found in carcinoma of the thoracic oesophagus, even when the tumour invades only the submucosa. Although lymph node status greatly influences the outcome, the pattern of early lymphatic spread has not been investigated, and the role of lymph node dissection is still a matter of controversy. METHODS: A series of 110 patients with superficial carcinoma who underwent systematic extended lymph node dissection was investigated retrospectively. RESULTS: Lymph node involvement was found in 0 per cent (none of nine), 23 per cent (five of 22) and 49 per cent (38 of 78) of tumours that invaded the lamina propria, muscularis mucosa and submucosa respectively. Anatomically distant lymph nodes (recurrent nerve nodes and perigastric nodes) were involved more frequently than other intrathoracic nodes adjacent to the main tumour. Only three patients had involvement limited to the intrathoracic group, and in carcinoma that invaded only the muscularis mucosae, all metastatic nodes were located at the thoracocervical junction or in the abdomen. The 5-year survival rate was 89 per cent in the node-negative group and 54 per cent in the node-positive group (P < 0.0003). CONCLUSION: The recurrent nerve nodes and perigastric nodes are the principal proximal regional lymph nodes involved in superficial carcinoma of the thoracic oesophagus. Systematic lymph node dissection, which included these nodes, yielded an acceptable and favourable outcome in patients with node-positive superficial carcinoma.

Carcinoma, Squamous Cell↗

PubMed2006

[Sentinel lymph node in oral and oropharyngeal epithelial tumors].

Carcinomatous metastases in regional lymph nodes worsen substantially the prognosis of patients with oral cavity and oropharyngeal cancer. Due to the high probability of occult metastasis (about 30%), during surgical resection of the primary tumor usually also elective dissection of lymph nodes is performed. Opinions on the extent of the elective neck dissection still differ, whereas selective dissection increasingly gains in importance. The aim of selective dissections, based on the predictability of formation of metastases, is the identification and exstirpation of the sentinel lymph node. In this prospective study the applicability of the concept of the sentinel lymph node in patients with oral cavity and oropharyngeal cancer was analysed. 12 patients with oral cavity and orophangeal cancer, staging T1-T3, all N0 (examined by palpation and sonography) were included. The localization of the sentinel(s) was determined preoperatively by radioisotope (Tc Nanocolloid). Sentinel(s) were identified first with a gamma probe (Neoprobe 2000); we then injected methylene blue into the peritumoral area for easier detection of the sentinel(s). The sentinels were removed and sent for frozen section examination. Regardless of the findings of the frozen section examination modified dissection was carried out. Later we compared frozen sections with paraffin microtome sections of sentinel(s) and of other exstirpated neck lymph nodes. We could identify the sentinel lymph node in all patients, in 6/12 patients we found several sentinels. If sentinels were not affected by tumor cells, there were no metastases in the downstream neck lymph nodes either. If in the sentinel lymph nodes no metastases can be determined, eliminating the environment alone could be sufficient. However, this assumption requires verification in a larger patient group.

Adult↗

PubMed1976

Prognostic significance of regional lymph node histology in cancer of the bladder.

The regional lymph nodes from 47 patients with carcinoma of the bladder who had undergone radical cystectomy and bilateral pelvic lymphadenectomy were classified into 3 histologic patterns that correlated with immunologic function. Lymph nodes were designated as stimulated if they exhibited prominent germinal centers (B cell proliferation) and expansion of the deep cortex (T cell proliferation), depleted if they appeared markedly hypocellular and fibrotic, and unstimulated if they resembled a normal resting lymph node. Correlation of the histologic pattern with the extent of disease revealed that patients whose nodes appeared stimulated had fewer metastases (p less than 0.05) than those with either unstimulated or unstimulated combined with a depleted pattern. A markedly improved 5-year survival rate was seen in patients with a stimulated pattern (p less than 0.0001) compared to those patients who exhibited a depleted and/or unstimulated lymph node pattern. The survival advantage related to the stimulated pattern was observed primarily among patients with advanced disease. It is suggested that stimulated nodes reflect proliferation of T and B lymphocytes engaged in cell-mediated and humoral immune responses to the bladder tumor and that this favorably influenced survival in those patients. Patients whose lymph nodes showed a depleted pattern fared poorly despite the extent of the disease and those with an unstimulated pattern were intermediate in survival. A depleted pattern may represent a state of local immune paralysis, exhaustion of the draining lymph nodes as a result of exposure to excess tumor-derived products such as antigen or toxic substances or simply an atrophic node incapable of response. In the absence of a local immune response such patients might be expected to do poorly. These results suggest that morphologic evaluation of the lymph nodes regional to bladder cancer may provide a clue to their immunologic function and a more accurate guide to prognosis of patients with this neoplasm.

Adult↗

PubMed2003

Rationale for central and bilateral lymph node dissection in sporadic and hereditary medullary thyroid cancer.

UNLABELLED: A retrospective study was performed on 101 consecutive medullary thyroid cancer (MTC) patients who underwent at Institut Gustave-Roussy (IGR) total thyroidectomy with central and bilateral lymph node dissection. At histology, lymph node metastases were found in 55% of patients. In sporadic MTC, lymph node metastases were observed in the central compartment in 50% of patients, in the ipsilateral jugulocarotid chain in 57%, and in the contralateral jugulocarotid chain in 28%. In hereditary MTC, lymph node metastases were identified in the central compartment in 45% of patients, in the ipsilateral jugulocarotid chain in 36%, and in the contralateral jugulocarotid chain in 19%. Contralateral lymph nodes were found in 37% of metastatic patients with an unilateral tumoral involvement of the thyroid gland. A strong association was observed between tumor size and lymph node involvement for both hereditary and sporadic MTC (P < 0.02). Permanent hypoparathyroidism occurred in 4% of patients and laryngeal nerve palsy in 5%. An undetectable calcitonin level was obtained after surgery in 61% of patients, in 95% of patients without lymph node metastases, and in 32% of patients with lymph node metastases. Among patients with lymph node involvement, undetectable calcitonin level was obtained in 57% of patients with less than or with 10 lymph node metastases and in 4% of patients with more than 10 (P < 0.01). IN CONCLUSION: 1) lymph node metastases occur early in the course of MTC; 2) the pattern of lymph node metastatic distribution in neck areas varied between patients and was not related to the thyroid tumor size; 3) contralateral lymph node metastases were observed even in patients with small thyroid tumor; 4) total thyroidectomy with central and complete bilateral neck dissection should be performed routinely in all patients with sporadic and hereditary MTC, even in those with small thyroid tumors-a contralateral neck dissection may be avoided only in sporadic MTC patients with unilateral involvement of the thyroid gland in the absence of central and ipsilateral neck involvement; and 5) the number of lymph node metastases was predictive of biological cure after surgery.

Adult↗

PubMed2004

Anatomical extent of lymph node dissection: impact on men with clinically localized prostate cancer.

PURPOSE: This study evaluates the influence of the anatomical extent of pelvic lymph node dissection performed at radical prostatectomy on lymph node yield, staging accuracy and time to prostate specific antigen progression. MATERIALS AND METHODS: Between February 1992 and April 2003, 2 surgeons at 1 hospital performed 2,135 and 1,865 radical prostatectomies with pelvic lymph node dissection, respectively. One surgeon routinely performed an extended lymph node dissection while the second surgeon performed a limited pelvic lymphadenectomy. The number of lymph nodes extracted and the number of patients with positive lymph nodes detected were analyzed and compared. Kaplan-Meier analysis was used to compare the biochemical recurrence-free survival between the 2 groups of patients with occult nodal disease. RESULTS: Extended lymph node dissection removed more lymph nodes (mean 11.6 vs 8.9, p<0.0001) and detected more lymph node positive disease (3.2% vs 1.1%, p<0.0001) than the more anatomically limited technique. This finding held true for patients across all pathology groups. Among men with lymph node positive disease involving less than 15% of extracted nodes, the 5-year prostate specific antigen progression-free rate for extended lymph node dissection was 43% versus 10% for the more limited lymph node dissection (p = 0.01). CONCLUSIONS: Compared to limited lymph node dissection, extended pelvic lymphadenectomy appears to identify men with positive lymph nodes more frequently. A significant benefit in biochemical recurrence-free survival may exist for certain subgroups undergoing the extended dissection. However, because the results may be influenced by stage migration, longer followup is necessary to determine whether the apparent therapeutic effect persists.

Adult↗

PubMedDate not supplied

Surgical outcome in early gastric cancer with lymph node metastasis.

BACKGROUND/AIMS: Definitive surgical management of early gastric cancer with lymph node metastasis has not been established. This paper describes the clinico-pathologic characteristics of early gastric cancer with lymph node metastasis. MATERIALS AND METHODS: A retrospective study of early gastric cancer with lymph node metastasis (32 patients) was performed to compare clinico-pathologic features with patients without lymph node metastasis (283 patients). RESULTS: All patients with lymph node metastasis had submucosal gastric invasion. The incidence of histologically proven curative resection in patients with lymph node metastasis was significantly lower than in those without metastasis (40.6% versus 93.3%). The 5-year survival rate was poorer in patients with positive nodes than in those with negative nodes (83.8% versus 96.2%). Recurrence was more frequent in patients with involved nodes (12.5% versus 0.4%). Lymph node metastasis was more frequent with the following: submucosal invasion, tumor over 5 cm in size, positive venous involvement, and an advanced growth pattern. CONCLUSIONS: Pre-operative and intra-operative evaluation for lymph node metastasis is essential for the appropriate surgical treatment of early gastric cancer.

Adenocarcinoma↗

PubMed1975

In vitro studies of axillary lymph node cells in patients with breast cancer.

A total of 170 axillary lymph nodes were obtained from fresh mastectomy specimens from 81 women with breast cancer. Lymph node cells were tested in vitro for T and B cells by the rosette technique and immunofluorescence microscopy and for functional capacity by response to the mitogens phytohemagglutinin (PHA) and concanavalin A. T cells showed a wide range of relative values: 32-80 percent, with a mean of 63.5 percent. B cells defined by the presence of surface immunoglobulins ranged from 14 to 61 percent (mean, 35.8 percent); those defined by the presence of C3 receptors, from 8 to 54 percent (mean, 24.9 percent); and those defined by the presence of IgG-specific (Fc) receptors, from 10 to 45 percent (mean, 27.5 percent). Cells with the C3 and Fc receptors constituted approximately two-thirds of the cells not binding spontaneously to sheep red blood cells (non-SRBC-R), whereas virtually all non-SRBC-R stained for surface immunoglobulins. The proportion of T and B cells and the response to mitogens varied widely among nodes and among patients. Differences were significant between values observed in young and old patients, nodes with and those without metastatic disease, and lymph nodes with different morphology. Lymph nodes from patients over 60 years old showed a higher proportion of B cells and a lower proportion of T cells than did those from patients 45 years of age or younger. Lymph nodes with disease metastic to them also showed a higher percent of B cells and a lower percent of T cells than the nodes that did not have metastatic disease. Lymph nodes with lymphocyte predominance showed a relatively high proportion of T lymphocytes, a high PHA response, and a low content of B lymphocytes. By contrast, lymph nodes with germinal-center predominance showed a relatively low content of T cells, a low PHA response, and a relatively high proportion of B lymphocytes.

Adult↗

PubMed2004

[Lymph nodes mapping for detection of sentinel nodes in patients with papillary thyroid cancer].

We examined the feasibility of sentinel lymph node biopsy for papillary thyroid cancer. In the dye injection method, 1% of isosulfan blue dye was injected around the tumor of 32 patients intra-operatively, and in the radioisotope (RI) colloid injection method, 99mTc-tin colloid was injected in 23 patients 1 day preoperatively. Lymph node mapping for detection of sentinel nodes was performed after thyroidectomy and central and modified lateral neck lymph node dissections. All dissected nodes were examined postoperatively by hematoxylineosin staining to determine whether or not metastasis was present. In the dye injection method, sentinel lymph nodes were identified in 30 (94%) of the 32 patients. Lymph node metastases were found in 14 patients, and some sentinel lymph nodes had papillary cancer metastasis in 13 patients. There was only 1 false-negative case. Sensitivity and accuracy of sentinel lymph node biopsy was 93% (13/14) and 97% (29/30). With the RI method, detection rate, sensitivity and accuracy of sentinel lymph node biopsy was 96% (22/23), 90% (9/10) and 95% (21/22), respectively. Our preliminary study indicated that sentinel lymph node biopsy was feasible in patients with thyroid cancer. It may be helpful in avoiding unnecessary lymph node dissection and improving quality of life in patients with thyroid cancer.

Carcinoma, Papillary↗

PubMed1996

[Risk factors for lymph node metastasis in malignant melanoma].

The elective and the therapeutic lymph node dissection are discussed for therapy of malignant melanoma. We analyzed the significance of prognostic factors for the development of lymph node metastasis. Reviewing the records of 388 patients with malignant melanoma between 1983 and 1994, 230 patients were classified for clinical stadium I and II at the time of primary therapy. 148 patients (64.3%) developed positive lymph nodes. Sex, age and ulceration tendency had no significant influence on prognosis. The nodular type of melanoma metastasized significantly most frequently in the regional lymph nodes (75.6%), followed by the the acrolentiginous melanoma 64.0%), the lentigo maligna melanoma (60.0%) and the superficial spreading melanoma (45.7%). With tumor staging from pT1 (38.5%) to pT4 (78.1%) positive lymph nodes significantly developed. The malignant melanomas of the trunk had the strongest tendency for lymph node metastasis. For patients with histologically confirmed nodular malignant melanoma, tumor staging pT3 and pT4 or malignant melanomas of the trunk we see the indication for an elective lymph node dissection.

Adult↗

PubMed2003

Patterns of recurrence after sentinel lymph node biopsy for breast cancer.

BACKGROUND: Sentinel lymph node biopsy (SLNB) is gaining acceptance as an alternative to axillary lymph node dissection. The purpose of this study was to determine the frequency and pattern of disease recurrence after SLNB. METHODS: Two-hundred twenty-two consecutive patients undergoing SLNB from April 6, 1998, to October 27, 1999, and who were >or=24 months out from their procedure were identified from a prospectively maintained database. Retrospective chart review and data analysis were performed to identify variables predictive of recurrence. RESULTS: The median patient follow-up was 32 months (range, 24-43 months). A total of 159 patients (72%) were sentinel lymph node (SLN) negative and had no further axillary treatment. Five of these patients (3.1%) developed a recurrence (one local and four distant), with no isolated regional (axillary) recurrences. Sixty-three patients (28%) were SLN positive and underwent a subsequent axillary lymph node dissection. Six of these patients (9.5%) developed a recurrence (three local, one regional, and two distant). Pathologic tumor size (P <.001), lymphovascular invasion (P =.018), and a positive SLN (P =.048) were all statistically significantly associated with disease recurrence. CONCLUSIONS: With a minimum follow-up of 24 months, patients with a negative SLN and no subsequent axillary treatment demonstrate a low frequency of disease recurrence. This supports the use of SLNB as the sole axillary staging procedure in SLN-negative patients.

Adult↗

PubMed2003

Association between lymph node size and metastasis in dogs with oral malignant melanoma: 100 cases (1987-2001).

OBJECTIVE: To determine the association between lymph node size and metastasis and to assess measurement of lymph node size as an accurate and reliable means of tumor staging in dogs with oral malignant melanoma. DESIGN: Retrospective study. ANIMALS: 100 dogs with histologically confirmed oral malignant melanoma. PROCEDURE: Clinical records for dogs with oral malignant melanoma were reviewed. Data regarding size and results of cytologic or histologic examination of lymph nodes were evaluated. The association between lymph node size and metastasis was determined. RESULTS: Forty-seven (47%) dogs, of which 23 (49%) had enlarged mandibular lymph nodes, had no cytologic or histologic evidence of metastasis. Of 53 (53%) dogs with cytologic or histologic evidence of mandibular lymph node metastasis, 37 (70%) had enlarged mandibular lymph nodes, and 16 (30%) had mandibular lymph nodes of normal size. Overall, 16 of the 40 (40%) dogs with normal-sized lymph nodes had microscopic evidence of metastatic disease. Sensitivity and specificity of lymph node size as a predictor of metastasis were 70 and 51%, respectively, and the positive and negative predictive values were 62 and 60%, respectively. CONCLUSIONS AND CLINICAL RELEVANCE: Although a significant relationship was identified between lymph node size and metastasis to the lymph node, this association did not appear strong enough to be clinically relevant. Results suggest that lymph node size alone is insufficient for accurate clinical staging of oral malignant melanoma in dogs; cytologic or histologic examination of regional lymph nodes should routinely be performed, regardless of size of those nodes.

Animals↗

PubMed1993

Diagnostic and prognostic significance of clonal T-cell receptor beta gene rearrangements in lymph nodes of patients with mycosis fungoides.

In this study, 25 involved and uninvolved lymph nodes from 22 patients with mycosis fungoides (MF) and seven dermatopathic lymph nodes from patients with benign skin disorders were studied for the presence of clonal T-cell receptor beta (TCR beta) gene rearrangements by Southern blot analysis. These results were correlated with the histological classification, follow-up data, and survival. The results of the histological classification and Southern blot analysis were concordant in 26 of 32 cases. Clonal TCR beta gene rearrangements were found in all six MF lymph nodes showing (partial) effacement of the normal lymph node architecture, but in none of the eight uninvolved dermatopathic MF lymph nodes and in none of the seven dermatopathic control lymph nodes. In addition, in 5 of 11 dermatopathic MF lymph nodes that were considered to have early involvement by MF at histological examination, clonal TCR beta gene rearrangements were detected. In the group of MF patients with dermatopathic lymphadenopathy, patients with detectable clonal T-cell populations had a significantly shorter survival than patients without such a population (P < 0.01). The results of this study indicate that within the group of dermatopathic MF lymph nodes, prognostically different groups can be distinguished and that TCR beta gene rearrangement analysis may be an important adjunct in the early diagnosis of lymph node involvement by MF.

Clone Cells↗

PubMed2007

Lymphatic vessel density at the site of deepest penetration as a predictor of lymph node metastasis in submucosal colorectal cancer.

PURPOSE: Lymph node metastasis is an important factor that influences curability after endoscopic treatment of submucosal colorectal cancer. This study was designed to determine the usefulness of identification of lymphatic vessels by immunohistochemistry in predicting lymph node metastasis of submucosal colorectal cancer. METHODS: Lymphatic involvement was assessed by hematoxylin and eosin staining and podoplanin immunostaining on samples resected from 268 patients with submucosal colorectal cancer. Lymphatic vessel density was estimated by two investigators by average count of three fields (x200) in the area of greatest number of podoplanin-positive capillaries at the site of deepest submucosal penetration. Relations with other clinicopathologic parameters also were investigated. RESULTS: Lesions with high lymphatic vessel density (> or =9 vessels per field) showed a significantly greater incidence of lymph node metastasis than did those with low lymphatic vessel density (<9 vessels per field; 23.3 vs. 8.4 percent). By multivariate analysis, lymphatic vessel density was determined to be an independent risk factor for lymph node metastasis of submucosal colorectal cancer (P = 0.0044). Lymphatic vessel density also correlated with tumor budding and the degree of inflammation at the invasive front. CONCLUSIONS: Identification of lymphatic vessels by podoplanin immunostaining provides objective and accurate evaluation of lymphatic involvement. Lymphatic vessel density at the site of deepest penetration is a useful predictor of lymph node metastasis of submucosal colorectal cancer.

Colorectal Neoplasms↗

PubMed2001

Influence of the number of lymph nodes examined on staging of gastric cancer.

BACKGROUND: Nodal staging for gastric cancer according to the 1997 Union Internacional Contra la Cancrum tumour node metastasis classification is based on the number of metastatic lymph nodes. The aim of this study was to evaluate whether the number of lymph nodes examined affected staging of gastric cancer. METHODS: A retrospective study was performed in 4789 consecutive patients with gastric cancer, who had undergone curative resection (R0) from 1986 to 1995. Patients were classified according to the number of nodes examined. The number of metastatic lymph nodes and stage-stratified survival were compared. RESULTS: There were significant differences in the number of metastatic lymph nodes and survival in stage IIIA between patients with 15 or more lymph nodes and those with fewer than 15 nodes. In analysis restricted to patients with 15 or more nodes, stage-stratified survival did not vary significantly with lymph node yields for any stage except IIIB, in which there was a significant difference between the subgroup with fewer than 20 examined lymph nodes and patients with 35 or more nodes. CONCLUSION: The number of lymph nodes examined did not significantly affect node staging of gastric cancer as long as at least 15 nodes were examined. For stage IIIB, more than 15 lymph nodes may be required for optimal staging.

Adult↗

PubMedDate not supplied

Evaluation of an ex vivo murine local lymph node assay: multiple endpoint comparison.

The local lymph node assay (LLNA) is used to assess the skin sensitization potential of chemicals. In the standard assay, mice are treated topically on the dorsum of both ears with test substance for 3 days. Following 2 days of rest, the initiation of the hypersensitivity response is evaluated by injecting (3)H-thymidine into a tail vein, and then measuring the levels of radioisotope incorporated into the DNA of lymph node cells draining the ears. In the current study, BALB/c mice were treated with the contact sensitizers hexylcinnamic aldehyde (HCA) and oxazolone, and the nonsensitizer methyl salicylate. The proliferative response of lymph node cells was evaluated in an ex vivo assay, in which isolated cells were cultured in vitro with (3)H-thymidine. Treatment of mice with HCA at 5-50% resulted in concentration-related increases in (3)H-thymidine incorporation, with stimulation indices ranging from 3 to 14. Low animal-to-animal variability was seen in three replicate assays testing HCA at 25%. As anticipated, the proliferative response induced by the potent sensitizer oxazolone at 0.25% was greater than HCA at all concentrations tested. Stimulation indices of 1.5 and 3 were seen in two independent experiments with methyl salicylate. These equivocal findings were likely due to the irritancy properties of the compound. Importantly, measuring ex vivo (3)H-thymidine incorporation was more sensitive than evaluating lymph node weight and cellularity, and in vitro bromodeoxyuridine incorporation. Furthermore, the results of the ex vivo LLNA were comparable to the standard assay. This study provided evidence that supports the use of an ex vivo LLNA for hazard assessment of contact hypersensitivity.

Acrolein↗