ABSTRACT
<p><b>OBJECTIVE</b>Paraaortic lymph nodes dissection in advanced gastric carcinoma is controversial. Investigation of micrometastasis in these critical lymph nodes is important in the evaluation of prophylactic lymphadenectomy.</p><p><b>METHODS</b>A total of 2 339 lymph nodes, including 390 paraaortic nodes, obtained from 47 patients with advanced gastric carcinoma were examined immunohistochemically using cytokeratin antibody.</p><p><b>RESULTS</b>Paraaortic lymph node metastasis was found in 95 of 390 nodes of 14 patients by routine histological examination. Micrometastasis in the paraaortic lymph nodes was immunohistochemically detected in 45 of 295 negative nodes from 15 of 33 patients. The 5-year-survival rate in patients with paraaortic lymph node metastasis was 56.0% in the node negative group, 25.2% in the cytokeratin positive group and 9.0% in the hematoxilin and eosin positive group.</p><p><b>CONCLUSIONS</b>We have demonstrated a high rate of micrometastasis in the paraaortic lymph nodes of patients with advanced gastric carcinoma and have confirmed that prophylactic lymphadenectomy of these nodes is effective for such patients.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Immunohistochemistry , Keratins , Lymph Nodes , Chemistry , Pathology , Lymphatic Metastasis , Pathology , Neoplasm Staging , Prognosis , Stomach Neoplasms , Mortality , Pathology , Survival RateABSTRACT
Objective Tumors with accelerated growth or high malignancy are thought to undergo active angiogenesis. Whereas by far, there is few study concerning the combination of MIB-1 proliferation index (MIB-1 PI) and tumor angiogenesis in carcinomas to show their significance in relate to clinicopathological parameters. In the present study, we evaluated the significance of MIB-1 PI and angiogenesis in early stage of gastric cancer. Our focus was especially on the combination of MIB-1 PI and angiogenesis in relate to lymph node metastasis. Methods Specimens from 95 patients with early gastric cancer were studied by means of immunohistochemistry using monocional MIB-1 and factor Ⅷ related antigen antibodies. Results The mean MIB-1 PI and microvessel count were 22.9％ and 34.7,respectively. The MIB-1 PI did not correlate with microvessei count. Both correlated with depth of tumor invasion,lymphatic vessel invasion and lymph node metastasis. Multivariate analysis showed that combined high MIB-1 PI/hypervascularity, as well as lymphatic vessel invasion and tumor size were independent factors that impact on lymph node metastasis. Conclusion A combination of the high MIB-1 PI/hypervascularity is a factor that related to lymph node metastasis in early gastric cancer.