Significance of metastasis detected by molecular techniques in sentinel nodes of patients with gastrointestinal cancer

• Published in: Annals of surgical oncology Vol. 11; no. S3; pp. 250 - 254S
• Main Authors: Matsuda, Jun-ichi, Kitagawa, Yuko, Fujii, Hirofumi, Mukai, Makio, Dan, Katsuaki, Kubota, Tetsuro, Watanabe, Masahiko, Ozawa, Soji, Otani, Yoshihide, Hasegawa, Hirotoshi, Shimizu, Yoshimasa, Kumai, Koichiro, Kubo, Atsushi, Kitajima, Masaki
• Format: Journal Article
• Language: English
• Published: New York Springer Nature B.V 01.03.2004
• ISSN: 1068-9265; 1534-4681
• DOI: 10.1007/BF02523639

The clinical significance of micrometastasis in sentinel nodes (SNs) may differ in various organs. In particular, the prognostic value of SN micrometastases detected by reverse transcriptase-polymerase chain reaction (RT-PCR) is still controversial. We investigated the diagnostic and therapeutic significance of nodal molecular metastasis detected, by nested RT-PCR for cytokeratin (CK) 19 mRNA in gastrointestinal cancer. In 51 cases with GI tract cancer treated by standard curative resection, SNs were identified by a radio-guided method. In 10 of 51 patients, 25 SNs and 3 non-SNs were histologically negative and RT-PCR positive. Three non-SNs with positive CK19 mRNA were randomly sampled from the same basin where histologically positive SNs were identified. Immunohistochemical analysis of six additional step sections obtained at 30-μm intervals with use of an anticytokeratin antibody showed clearly recognizable histological metastases in 4 of 25 histologically negative/RT-PCR-positive SNs (16%). In one case of esophageal squamous cell carcinoma with nodal micrometastasis identified by CK19 RT-PCR, extranodal local recurrence in the SN basin (left supraclavicular basin) was observed 6 months postoperatively. These findings suggest that nodal micrometastasis detected by nested RT-PCR has some clinical significance in GI cancer. Molecular assessment of the SN may be a valuable tool to complement routine histological examination for GI cancers.