Identification of occult micrometastases in pericolic lymph nodes of Dukes' B colorectal cancer patients using monoclonal antibodies against cytokeratin and CC49. Correlation with long‐term survival
Joel K. Greenson,Craig E. Isenhart,Robert R. Rice,Cathy Mojzisik,David P. Houchens,Edward W. Martin +5 more
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TLDR
It is postulate that patients with Dukes' B colon cancer who die of their disease have occult micrometastases in their pericolic lymph nodes at the time of original diagnosis.Abstract:
Background. Patients with transmurally invasive, lymph node negative colorectal carcinoma (Dukes' B) have a 5-year survival rate ranging from 53.9% to 84.9%. The authors postulate that patients with Dukes' B colon cancer who die of their disease have occult micrometastases in their pericolic lymph nodes at the time of original diagnosis. In an attempt to identify these occult micrometastases, pericolic lymph nodes from Dukes' B colon cancer resections were stained retrospectively with antibodies against cytokeratin (anti-keratin AE1/AE3, Boehringer Mannheim, Indianapolis, IN) and CC49 (a second-generation monoclonal antibody directed against TAG-72.
Methods. The authors reviewed all Dukes' B (transmurally invasive, lymph node negative) primary colorectal carcinoma resection specimens from the surgical pathology files of the Ohio State University Hospitals between 1984 and 1987. Survival data were obtained from the Tumor Registry of the Arthur G. James Cancer Hospital and Research Institute, Columbus, Ohio. The results were analyzed by univariate and multivariate analysis.
Results. Fifty cases with 568 lymph nodes (11.3 per case) were examined with each antibody using standard immunoperoxidase techniques. Positive staining for cytokeratin was seen in 14 patients (33 lymph nodes), 6 of whom died of colon cancer within 66 months (43%) Only 1 of the 36 patients with cytokeratin-negative lymph nodes died of colon cancer over the same time period (3%, P = 0.0009 univariate, P = 0.0013 multivariate). There was no significant difference in survival between the CC49-positive and CC49-negative groups.
Conclusion. Immunoperoxidase techniques are capable of identifying micrometastatic disease in lymph nodes missed by routine hematoxylin and eosin staining. Further, the presence of cytokeratin-positive cells within lymph nodes correlated with a significantly poorer prognosis. Therefore, cytokeratin staining of pericolic lymph nodes in patients with Dukes' B colorectal cancer is recommended. Larger multicenter studies are needed, however, to confirm these results and to evaluate the appropriateness of adjuvant chemotherapy in patients whose disease is upstaged by immunohistochemical staining.read more
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References
More filters
Journal ArticleDOI
Use of avidin-biotin-peroxidase complex (ABC) in immunoperoxidase techniques: a comparison between ABC and unlabeled antibody (PAP) procedures.
TL;DR: The use of avidin-biotin interaction in immunoenzymatic techniques provides a simple and sensitive method to localize antigens in formalin-fixed tissues.
Journal ArticleDOI
Genetic alterations during colorectal-tumor development.
Bert Vogelstein,Eric R. Fearon,Stanley R. Hamilton,Scott E. Kern,Ann C. Preisinger,Mark Leppert,A M Smits,Johannes L. Bos +7 more
TL;DR: It is found that ras-gene mutations occurred in 58 percent of adenomas larger than 1 cm and in 47 percent of carcinomas, which are consistent with a model of colorectal tumorigenesis in which the steps required for the development of cancer often involve the mutational activation of an oncogene coupled with the loss of several genes that normally suppress tumors.
Journal ArticleDOI
The classification of cancer of the rectum
TL;DR: The scope and limitations of histological grading by Broders' method are discussed and the conclusions reached that grading of a tumour is also of value for prognosis, though not when applied to fragments removed for diagnosis.
Journal ArticleDOI
Allelotype of colorectal carcinomas
Bert Vogelstein,Eric R. Fearon,Scott E. Kern,Stanley R. Hamilton,Ann C. Preisinger,Yusuke Nakamura,Ray White +6 more
TL;DR: In addition to its implications concerning the genetic events underlying tumorigenesis, tumor allelotype may provide a molecular tool for improved estimation of prognosis in patients with colorectal cancer.
Journal ArticleDOI
The Spread of Rectal Cancer and its Effect on Prognosis
Cuthbert E. Dukes,H J R Bussey +1 more
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