Dukes’ B 대장암 환자에서 림프절의 미세전이와 예후와의 상관관계에 대한 연구
Occurrence and Prognostic Implications of Lymph Node Micrometastases in Patients with Dukes’ B Colorectal Carcinoma
최윤영, 최홍조, 정갑중, 김상순, 홍숙희,
소속 상세정보
최윤영 ( Choi Yun-Young )
동아대학교 의과대학 외과학교실
최홍조 ( Choi Hong-Jo )
동아대학교 의과대학 외과학교실
정갑중 ( Jung Ghap-Joong )
동아대학교 의과대학 외과학교실
김상순 ( Kim Sang-Sun )
동아대학교 의과대학 외과학교실
홍숙희 ( Hong Sook-Hee )
동아대학교 의과대학 병리학교실
KMID : 0356720010170030141
Abstract
Purpose: Whereas lymph node metastases in colorectal carcinoma are important prognostic factor, the prognostic relevance of occult tumor cells in lymph nodes has not been elucidated yet. Aims of this study were to assess the incidence of micrometastases of lymph nodes in patients with Dukes’ B colorectal carcinoma and to investigate the correlation between nodal micrometastases and malignant potential to determine whether micrometastases of lymph nodes have prognostic significance, using an anti-cytokeratin immunohistochemical technique.
Methods: To evaluate the incidence of lymph node micrometastases in patients with Dukes’ B colorectal carcinoma, 1160 lymph nodes taken from 65 patients (17.9 per case) were assessed by immunohistochemical technique using a monoclonal anti-human cytokeratin (MNF 116). Clinicopathologic parameters and survival rate were compared between patients with and without micrometastases.
Results: The incidence of nodal involvement by tumor cells in 65 patients with Dukes’ B colorectal carcinoma (41 colon, 22 rectum, 2 synchronous cancer) was 30.8% (20 cases) and nodal positivity 3.2% (33/1423 nodes) by the immunostaining. No correlations were observed between the incidence of cytokeratin positivity and various clinicopathologic parameters, including preoperative CEA level, tumor site and size, histologic differentiation, pT stage, vascular invasion and lymphatic invasion and rate of recurrence. There was no difference in five-year survival estimated by Kaplan-Meier lifetable method between the micrometastases negative and positive groups (94.8% and 94.1%, respectively).
키워드
결직장암;미세전이;림프절
Colorectal cancer;Micrometastasis;Lymph node
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