Dukes´ B 병기의 대장암 환자에서 Cytokeratin-19 항체를 이용한 림프절 미세전이의 발견
Identification of Lymph Node Micrometastases in Dukes´ B Colorectal Cancer Patients Using Monoclonal Antibodies against Cytokeratin-19
신응진, 김현철, 임철완, 조규석, 주종우, 백무준, 박내경, 장용석, 김재준, 송옥평, 이민혁,
소속 상세정보
신응진 ( Shin Eung-Jin )
순천향대학교 의과대학 외과학교실
김현철 ( Kim Hyung-Chul )
순천향대학교 의과대학 외과학교실
임철완 ( Lim Chul-Wan )
순천향대학교 의과대학 외과학교실
조규석 ( Cho Gyu-Seok )
순천향대학교 의과대학 외과학교실
주종우 ( Chu Chong-Woo )
순천향대학교 의과대학 외과학교실
백무준 ( Baek Moo-Jun )
순천향대학교 의과대학 외과학교실
박내경 ( Park Nae-Kyung )
순천향대학교 의과대학 외과학교실
장용석 ( Jang Yong-Seog )
순천향대학교 의과대학 외과학교실
김재준 ( Kim Jae-Joon )
순천향대학교 의과대학 외과학교실
송옥평 ( Song Ok-Pyung )
순천향대학교 의과대학 외과학교실
이민혁 ( Lee Min-Hyuk )
순천향대학교 의과대학 외과학교실
KMID : 0371320040660050385
Abstract
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 recurrenee 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 anainst 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 significalltly 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 micrometaslases 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.
키워드
대장암;림프절;미세전이;Cytokeratin-19;CEA;Colorectal cancer;Lymph node;Micrometastases
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