Clinical significance of lymph node micrometastasis detection in determining the stage of gastric cardia adenocarcinoma

doi:10.3877/cma.j.issn.1674-0793.2013.05.011

Abstract

Abstract:

Objective

To evaluate the significance of lymph node micrometastasis in determining the stage of gastric cardia adenocarcinoma(GCA).

Methods

Three hundred and twenty-three lymph nodes from 48 GCA patients with negative lymph node by routine pathological examination were examined immunohistochemically(IHC) for the lymph nodes micrometastasis using anti-CK19 and anti-CD44v6 monoclonal anti-body. Clinical data were analyzed by statistical methods.

Results

Micrometastasis was found in 14 lymph nodes (4.33%) from 9 cases (18.75%). Nine of those patients were up-staged(from stageⅠA toⅠB in one patient, stageⅠB to ⅡA in three patients, stageⅡA to ⅡB in three patients, stageⅡA to ⅢA in one patient, stageⅡB to ⅢB in one patient). The rate of restaging was 18.75%.

Conclusion

IHC assay can increase the detection rate of lymph node metastasis and has a significant impact on the staging of GCA.

Key words: Gastric cardia adenocarcinoma, Lymph node, Micrometastasis, Neoplasm staging

Luo ZHANG, Qing LI, Fan-xian OUYANG, Zhi-gang LIN, Cheng-hui CHEN. Clinical significance of lymph node micrometastasis detection in determining the stage of gastric cardia adenocarcinoma[J]. Chinese Archives of General Surgery(Electronic Edition), 2013, 07(05): 374-377.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhptwkxwx.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-0793.2013.05.011

https://zhptwkxwx.cma-cmc.com.cn/EN/Y2013/V07/I05/374

Figures/Tables 4

References 10

1	Kofond SC, Brandt B, Breno J, et al. Long-term survival after curative resection for oseophageal and cardia cancer. Ugeskr Laeger, 2010, 172(21): 1597-1602.
2	陈宏，余元龙，邓庆炎, 等. 胃癌中血管内皮生长C的表达与淋巴结微转移的关系[J/CD]. 中华普通外科学文献:电子版, 2011, 5(5): 413-417.
3	张洛，冯笑山，王公平, 等. PN0贲门癌淋巴结微转移的检测及其临床意义. 中华外科杂志, 2008, 46(14): 1102-1103.
4	Katai H, Yoshimura K, Maruyama K, et al. Evaluation of the New International Union Against Cancer TNM staging for gastric carcinoma. Cancer, 2000, 88(8): 1796-1800.
5	李涛，王云海，何铁汉, 等. INC和RT-PCR法对检测胃癌区域淋巴结微转移的价值及意义. 中华普通外科杂志, 2009, 18(4): 322-325.
6	Kim JH, Park JM, Jung CW, et al. The significances of lymph node micrometastasis and its correlation with E-cadherin expression in pT1-T3N0 gastric adenocarcinoma. J Surg Oncol, 2008, 97(2): 125-130.
7	Hundahl SA, Phillips JL, Menck HR. The National Cancer Date Base Report on poor survival of U.S.gastric carcinoma patients treated with gastrectomy:Fifth Edition American Joint Committee on Cancer staging,proximal disease,and the "different disease" hypothesis. Cancer, 2000, 88(4): 921-932.
8	原超，范宗民，陈曦, 等. 淋巴结切除总数及阳性转移个数对贲门癌患者术后生存期的影响. 郑州大学学报(医学版), 2012, 47(5): 595-597.
9	Ru Y, Zhang L, Chen Q, et al. Detection and clinical significance of lymph node micrometastasis in gastric cardia adenocarcinoma. J Int Med Res, 2012, 40(1): 293-299.
10	Greene FL, Page DL, Fleming ID, et al. AJCC cancer staging manual. 6th ed. New York: Springer-Verlag, 2002: 223-240.

序号	肿瘤大小(cm)	分化程度	侵润深度	Lauren分型	TNM分期
1	2	中	T2	肠型	ⅠB→ⅡA
2	4	中	T2	弥漫型	ⅠB→ⅡA
3	3	高	T1	肠型	ⅠA→ⅠB
4	6	低	T3	弥漫型	ⅡA→ⅡB
5	8	低	T3	弥漫型	ⅡA→ⅢA
6	5.5	高	T3	肠型	ⅡA→ⅡB
7	3.5	低	T4	弥漫型	ⅡB→ⅢB
8	5	中	T2	弥漫型	ⅠB→ⅡA
9	2	低	T3	弥漫型	ⅡA→ⅡB

序号	肿瘤大小(cm)	分化程度	侵润深度	Lauren分型	TNM分期
1	2	中	T2	肠型	ⅠB→ⅡA
2	4	中	T2	弥漫型	ⅠB→ⅡA
3	3	高	T1	肠型	ⅠA→ⅠB
4	6	低	T3	弥漫型	ⅡA→ⅡB
5	8	低	T3	弥漫型	ⅡA→ⅢA
6	5.5	高	T3	肠型	ⅡA→ⅡB
7	3.5	低	T4	弥漫型	ⅡB→ⅢB
8	5	中	T2	弥漫型	ⅠB→ⅡA
9	2	低	T3	弥漫型	ⅡA→ⅡB

[1]	Jiajia Wang, Yunyun Zhan, Fan Jiang, Biyun Sun, Yu Bi, Rubing Li, Mei Peng. Application of Peyton's four-step teaching method in standardized residency training program for ultrasound segmentation of cervical lymph nodes [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2024, 21(08): 814-818.
[2]	Leping Li, Ronghua Zhang, Liang Shang. Laparoscopic lymph node dissection for adenocarcinoma of esophagogastric junction [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2025, 19(01): 9-12.
[3]	Hui Wu, Yongjun Nai, Xuesong Shi, Xiaowei Wei. Comparison of the effect of lateral lymph node dissection in descending rectal cancer by two anatomic approaches [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2025, 19(01): 40-43.
[4]	Shizhen Zhou, Xingya Zhu, Qinggang Yuan, Lixiang Liu, Kai Wang, Ji Miao, Chao Ding, Hao Wang, Wenxian Guan. Effect analysis of indocyanine green fluorescence imaging technique in laparoscopic lateral lymph node dissection of rectal cancer [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2025, 19(01): 44-47.
[5]	Baoxiong Zhuang, Haijun Deng. Single-incision plus one-port laparoscopic lateral lymph node dissection for rectal cancer [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(06): 601-601.
[6]	Yifei Gao, Genxiang Liu, Changhua Sun, Guangjun Zhou. Application of recurrent laryngeal nerve monitoring in unilateral thyroidectomy and central lymph node dissection without inflatable axillary approach [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(05): 483-486.
[7]	Jing Han, Shaolong Hao, Hua Kang. Retrospective analysis of clinical features of single-center thyroid carcinoma patients in Beijing [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(05): 490-493.
[8]	Jia Song, Bo Wang, Kailu Sun, Jiangfeng Shang, Danping Wu, Yi Zhao. Application of indocyanine green fluorescence imaging combined with methylene blue staining in sentinel lymph node biopsy of breast cancer [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(05): 498-501.
[9]	Yongqin Cai, Junju Wang, Jingjing Zhang. Application of different sequences of lower mediastinal lymph node dissection in Siewert type II esophagogastric junction adenocarcinoma [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(05): 562-565.
[10]	Hongshuai Cui, Liming Feng, Weiling Dong, Bo Han. The clinical effect of laparoscopic D3 radical resection of right half colon cancer plus IGLN dissection in the treatment of locally advanced hepatocolon carcinoma [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(05): 566-569.
[11]	Jingming Lu, Dawei Han, Yaoxing Ren, Tianxiao Huang, Junxi Xiang, Xufeng Zhang, Yi Lyu, Fumin Wang. Meta-analysis of lymph node metastasis prediction of intrahepatic cholangiocarcinoma based on preoperative radiomics [J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2024, 13(06): 852-858.
[12]	Shixiang Guo, Mingda Tan, Huaizhi Wang. Rethinking lymph node dissection in pancreatic head cancer [J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2024, 13(05): 625-628.
[13]	Ti Zhou, Jia Wu, Fang Han, Linwei Xu, Yuhua Zhang. Research progress in lymph node dissection for pancreatic cancer in the era of neoadjuvant therapy [J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2024, 13(05): 634-639.
[14]	Weiwei Zhang, Qi Chen, Heyu Weng, Liang Huang. Preliminary study on prediction of lymph node metastasis of T1 colorectal cancer by random forest model [J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2024, 13(05): 389-393.
[15]	Junwei Cui, Huali Cai, Yibin Hu, Hui Hu. Clinical value of methylene blue combined with marker clip and hook-wire localization in evaluation of axillary lymph node metastasis after neoadjuvant chemotherapy for breast cancer [J]. Chinese Journal of Clinicians(Electronic Edition), 2024, 18(07): 625-632.

Please choose a citation manager

Content to export