듀크스 병기 A, B 대장암에서 림프절 미세전이의 임상적 중요성
Clinical Significance of Lymph Node Micrometastasis in Dukes’ Stage A&B Colorectal Cancer: An Immunohistochemical Study
김태수, 황재관, 배선영, 김양희, 홍기천, 안승익, 허윤석, 한혜승, 우제홍,
소속 상세정보
김태수 ( Kim Tae-Soo )
인하대학교 의과대학 외과학교실
황재관 ( Hwang Jae-Gwan )
인하대학교 의과대학 외과학교실
배선영 ( Bae Sun-Young )
인하대학교 의과대학 외과학교실
김양희 ( Kim Yang-Hee )
인하대학교 의과대학 외과학교실
홍기천 ( Hong Kee-Chun )
인하대학교 의과대학 외과학교실
안승익 ( Ahn Seung-Ick )
인하대학교 의과대학 외과학교실
허윤석 ( Heo Yoon-Seok )
인하대학교 의과대학 외과학교실
한혜승 ( Han Hye-Seung )
인하대학교 의과대학 병리학교실
우제홍 ( Woo Ze-Hong )
인하대학교 의과대학 외과학교실
KMID : 0356719990150040253
Abstract
Purpose: Lymph node metastasis is the most important prognostic factor in colorectal cancer. However, 20∼30% of patients with lymph node negative colorectal cancer die of recurrent disease. We investigated whether the detection of micrometastasis is of any clinical significance in Dukes’ stage A & B colorectal cancer.
Methods: Ninety patients who underwent curative resection of colorectal cancer from Aug. of 1996 to Jan. of 1999 were entered the study. For examination, we used paraffin blocks of lymph nodes which were metastasis-free by conventional histopathology. After preparation of tissue blocks using the serial sectioning technique, the specimens were stained with immunohistochemical method using anticytokeratin antibody. And the hematoxylin-eosin staining was repeated.
Results: We disclosed micrometastases in 15 of 90 cases, mostly located in subcapsular sinuses. And in 8 of 15 cases, we also found metastases in repeated H&E staining. There were no significant relationship between the detection of micrometastases and the depth of wall invasion, the histological grade and the status of lymphovascular invasion. With median follow-up of 15 months, we found no significant difference in recurrence between the micrometasis positive and negative groups.
Conclusion: The result showed that the micrometastasis of lymph node in colorectal caner might increase the risk for development of tumor recurrence. But because of small numbers of recurrent cases and relatively short follow-up period, there was no statistically significant relationship between micrometastasis negative and positive groups.
키워드
Micrometastasis;Cytokeratin;Immunohistochemistry;Colorectal cancer
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