Dukes’ B 병기의 대장암 환자에서 Cytokeratin-19 항체를 이용한 림프절 미세전이의 발견

• Published in: Annals of surgical treatment and research Vol. 66; no. 5; pp. 385 - 390
• Main Authors: 신응진(Eung Jin Shin), 김형철(Hyung Chul Kim), 임철완(Chul Wan Lim), 조규석(Gyu Seok Cho), 주종우(Chong Woo Chu), 백무준(Moo Joon Baek), 박내경(Nae Gyung Park), 장용석(Yong Seok Jang), 김재준(Jae Joon Kim), 송옥평(Ok Pyung Song), 이민혁(Min Hyuk Lee)
• Format: Journal Article
• Language: Korean
• Published: 대한외과학회 01.05.2004
• Subjects: 일반외과학; 미세전이; 림프절; Lymph node; Micrometastases; Cytokeratin-19; Colorectal cancer; 대장암; CEA
• ISSN: 2288-6575; 2288-6796

Purpose: The aims of this study were to immunohistochemically identify lymph node micormetastases in Dukes' B colorectal cancer patients, and determine the relationship between lymph node micrometastases and other prognostic factors and recurrence rates. Methods: A retrospective analysis was conducted of 990 lymph nodes from Dukes' B 42 patients who had undergone radical colorectal resection. These lymph nodes were immunohistochemically examined with monoclonal antibodies against cytokeratin-19. The prognostic factors and recurrent rates were compared between patients with and without lymph node micrometastases. Results: Micrometastases were confirmed in 19 nodes (1.9%) from 9 patients (21.4%). No correlations were observed between micrometastases and the prognostic factors, with the exception of the preoperative CEA level. 8 of the 9 (88.9%) patients with micrometastases had preoperative CEA levels significantly elevated above 5 ng/ml (P＜0.0001). There were no significant differences in the recurrent rates (P=0.0572) between patients with and without micrometastases during the short term follow up period (14.8 months) at the 95% confidence interval, but there were significant differences at the 90% confidence interval. Conclusion: High preoperative CEA levels increase the risk for micrometastases, and the presence of micrometastases might increase the possibility of recurrence. Thus, a routine immunohistochemical technique for identifying micrometastases is recommended in the patients with a high preoperative CEA level. However, a more definite clinical significance of lymph node micrometastases awaits further extensive prospective studies. KCI Citation Count: 0