Expression and significance of cytokeratin 20 in lymph node micrometastasis of colorectal cancer in stage Ⅰ and Ⅱ patients

doi:10.3877/cma.j.issn.1674-0793.2018.02.006

Abstract

Abstract:

Objective

To assess the impact of cytokeratin 20 (CK20) in lymph node micrometastasis on clinical staging and prognosis of colorectal cancer (stage Ⅰ and stage Ⅱ) by immunohistochemistry.

Methods

The original histology of one hundred and thirty-seven patients with stage Ⅰ or stage Ⅱ colorectal cancer who had undergone curative resection from January 2010 to December 2011 in Zhongshan City People's Hospital was reviewed. Immunohistochemical staining was performed using CK20 antibodies on all the 945 lymph nodes. The clinical and follow-up data of those patients were used for survival analysis.

Results

(1) Micrometastases were observed in 15 lymph nodes (1.6%) of 10 patients (7.3%). (2) The presence of micrometastases was not related to gender, age, tumor size, location, operation methods, CEA expression of the primary lesion, histological type, vascular and nerve invasion. (3) The positive rate of CK20 was 16.7% (4/24) of micrometastasis patients in 5 years, higher than those without recurrence or metastasis 5.3% (6/113, χ²=2.282, P=0.131). (4) COX regression analysis showed that gender (P=0.359), age (P=0.917), tumor size (P=0.547), histological type (P=0.106), CEA expression of the primary lesion (P=0.069), tumor location (P=0.760), stage (P=0.069), and surgeries (P=0.350) were not related to prognosis; but the expression of CK20was closely related with the prognosis of the patients (P=0.033), the risk of death in patients with the presenceof lymph node micrometastasis was 3.224 times higher than those without metastasis (95% CI=1.100-9.451).

Conclusion

CK20 detection of lymph node micrometastasis in colorectal cancer can improve the clinical stage of colorectal cancer, affect the treatment plan and is related to the prognosis of the patients.

Key words: Colorectal neoplasms, Keratin-20, Lymph node, Micrometastasis, Recurrence

Shihai Zhou, Wenjun Peng, Hong Chen, Bing Chu, Hongzhi Luo, Qingyan Deng, Qingjiao Meng. Expression and significance of cytokeratin 20 in lymph node micrometastasis of colorectal cancer in stage Ⅰ and Ⅱ patients[J]. Chinese Archives of General Surgery(Electronic Edition), 2018, 12(02): 96-99.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhptwkxwx.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-0793.2018.02.006

https://zhptwkxwx.cma-cmc.com.cn/EN/Y2018/V12/I02/96

Figures/Tables 4

References 16

[1]	陈万青，郑荣寿，张思维, 等. 2013年中国恶性肿瘤发病和死亡分析[J]. 中国肿瘤, 2017, 26(1): 1-7.
[2]	Rahbari NN, Bork U, Motschall E, et al. Molecular detection of tumor cells in regional lymph nodes is associated with disease recurrence and poor survival in node-negative colorectal cancer: a systematic review and meta-analysis[J]. J Clin Oncol, 2012, 30(1): 60-70.
[3]	Uribarrena-Amezaga R, Ortego J, Fuentes J, et al. Prognostic value of lymph node micrometastasis in patients with colorectal cancer in Dukes stages A and B (T1-T4, N0, M0)[J]. Rev Esp Enferm Dig, 2010, 102(3): 176-186.
[4]	Kim JH, Rhee YY, Bae JM, et al. Loss of CDX2/CK20 expression is associated with poorly differentiated carcinoma, the CpG island methylator phenotype, and adverse prognosis in microsatellite-un-stable colorectal cancer[J]. Am J Surg Pathol, 2013, 37(10): 1532-1541.
[5]	程明荣，蔡元坤. 结直肠癌微转移基因的研究进展[J]. 国外医学（外科学分册）, 2005, 32(5): 366-371.
[6]	廖信芳，李柱，赵宋礼，等. CK20免疫组化检测Ⅱ期直肠癌淋巴结微转移对结局的影响[J]. 江西医药，2015，50(7):649-651.
[7]	吴泽宇，万进，赵刚, 等. 中下段直肠癌VEGF表达状况与淋巴结微转移的关系[J/CD]. 中华普通外科学文献（电子版），2007，1(1):45-47.
[8]	程明荣，程志俭，蔡元坤, 等. 结直肠癌淋巴微转移免疫组化检测及其意义[J]. 复旦学报（医学版）, 2010, 37(1): 29-33.
[9]	Moll R, Schiller DL, Franke WW. Identification of protein IT of the intestinal cytoskeleton as a novel type Ⅰ cytokeratin with unusual properties and expression patterns[J]. J Cell Biol, 1990, 111(2): 567-580.
[10]	郭朝阳，秦章禄，袁庆文, 等. 腹腔镜技术对结直肠癌淋巴结微转移的影响[J]. 实用临床医学, 2015, 16(3): 36-37, 69.
[11]	Märkl B, Herbst C, Cacchi C, et al. Prognostic significance of histologically detected lymph node micrometastases of sizes between 0.2 and 2 mm in colorectal cancer[J]. Int J Colorectal Dis, 2013, 28(7): 977-983.
[12]	Davies M, Arumugam PJ, Shah VI, et al. The clinical significance of lymph node micrometastasis in stage Ⅰ and stage Ⅱ colorectal cancer[J]. Clin Transl Oncol, 2008, 10(3):175-179.
[13]	Hara M, Hirai T, Nakanishi H, et al. Isolated tumor cell in lateral lymph node has no influences on the prognosis of rectal cancer patients[J]. Int J Colorectal Dis, 2007, 22(8): 911-917.
[14]	Oh TY, Moon SM, Shin US, et al. Impact on prognosis of lymph node micrometastasis and isolated tumor cells in stage Ⅱ colorectal cancer[J]. J Korean Soc Coloproctol, 2011, 27(2): 71-77.
[15]	于游，张才全. 淋巴结微转移检测对大肠癌病理分期的影响[J]. 中国老年学杂志, 2011, 31(21): 4095-4097.
[16]	Short SS, Stojadinovic A, Nissan A, et al. Adjuvant treatment of early colon cancer with micrometastases: results of a national survey[J]. J Surg Oncol, 2012, 106(2): 119-122.

组别		例数	CK20染色结果（例）		阳性率(%)	χ ²值	P值
组别		例数	阳性	阴性	阳性率(%)	χ ²值	P值
性别						0.076	0.783
	男	81	6	75	7.4
	女	56	4	52	7.1
年龄（岁）						0.001	0.975
	<60	61	5	56	8.2
	≥60	76	5	71	6.6
肿瘤大小（cm）						0.269	0.604
	>3	14	2	12	14.3
	≥3	123	8	115	6.5
组织学类型						2.871	0.090
	低级别	115	6	109	5.2
	高级别	22	4	18	18.2
CEA表达情况						0.191	0.662
	阴性	12	1	11	8.3
	阳性	125	9	116	7.2
肿瘤部位						0.106	0.745
	结肠	82	6	76	7.3
	直肠	55	4	51	7.3
血管及神经浸润						0.398	0.528
	无	134	9	125	6.7
	有	3	1	2	33.3
TNM分期						0	1.000
	I	51	4	47	7.8
	II	86	6	80	7.0
手术方式						0.670	0.413
	开腹	72	7	65	9.7
	腹腔镜	65	3	62	4.6
5年内复发或死亡						2.282	0.131
	是	24	4	20	16.7
	否	113	6	107	5.3

组别		例数	CK20染色结果（例）		阳性率(%)	χ ²值	P值
组别		例数	阳性	阴性	阳性率(%)	χ ²值	P值
性别						0.076	0.783
	男	81	6	75	7.4
	女	56	4	52	7.1
年龄（岁）						0.001	0.975
	<60	61	5	56	8.2
	≥60	76	5	71	6.6
肿瘤大小（cm）						0.269	0.604
	>3	14	2	12	14.3
	≥3	123	8	115	6.5
组织学类型						2.871	0.090
	低级别	115	6	109	5.2
	高级别	22	4	18	18.2
CEA表达情况						0.191	0.662
	阴性	12	1	11	8.3
	阳性	125	9	116	7.2
肿瘤部位						0.106	0.745
	结肠	82	6	76	7.3
	直肠	55	4	51	7.3
血管及神经浸润						0.398	0.528
	无	134	9	125	6.7
	有	3	1	2	33.3
TNM分期						0	1.000
	I	51	4	47	7.8
	II	86	6	80	7.0
手术方式						0.670	0.413
	开腹	72	7	65	9.7
	腹腔镜	65	3	62	4.6
5年内复发或死亡						2.282	0.131
	是	24	4	20	16.7
	否	113	6	107	5.3

Please choose a citation manager

Content to export