Incidence and Prognostic Implications of Lymph Node Micrometastases in Patients with Submucosal Gastric Cancer

PURPOSE: Whereas lymph node metastasis in gastric cancer is an important prognostic factor, the prognostic relevance of occult tumor cells in lymph nodes has not yet been elucidated. The aims of this study were to assess the incidence of micrometastases of lymph nodes in patients with submucosally invaded gastric cancer and to investigate whether micrometastases of lymph nodes have prognostic significance. METHODS: In order to evaluate the incidence of lymph node micrometastases in patients with submucosal gastric cancer, 1423 lymph nodes taken from 55 patients were assessed by immunohistochemical technique using a monoclonal anti-human cytokeratin-8. Clinicopathologic parameters and prognoses were compared between patients with and without micrometastases. RESULTS: The incidence of nodal involvement by tumor cells in 55 patients with submucosal gastric cancer increased from 20.0% (11 patients) by hematoxylin-eosin (H-E) staining to 30.8% (17 patients) by immunohistochemical staining. Nodal positivity in this study increased from 0.8% (12/1423 nodes) by H-E staining to 3.2% (45/1423 nodes) by immunohistochemical staining (p=0.003). The presence of cytokeratin positivity was not related to various clinicopathologic factors. As estimated by the Kaplan-Meier lifetable methods, there was no significant difference in the five-year survival rate between the micrometastases negative and positive groups (94.8% and 94.1%, respectively). CONCLUSION: The presence of nodal micrometastases detected by immunohistochemical technique is an interesting phenomenon, however clinically it seems to be of only weak prognostic value in submucosal gastric cancer.

Influence of Total Ginseng Saponin on the Blood Pressure of the Rat

This study is an attempt to investigate the effect of total Ginseng saponin (GTS) on the blood pressure of the rat and to elucidate its mechanism of action. GTS, when injeced into a femoral vein of the rat, caused dose-related fall in blood pressure with secondarily elevation of the blood pressure. The depressor effect of GTS was blocked by treatment of atropine and prazosin, but not affected by pretreatment with chlorisondamine or cyproheptadine. GTS inhibited significantly the pressor response evoked by norepinephrine. The pressor effect of GTS was not affected by treatment with atropine or cyproheptadine, but was attenuated markedly by pretreatment with chlorisondamine. From the above mentioned results, it is thought that GTS produces the pressor and the depressor actions in the rat, and that its depressor response is exerted partly through the stimulation of cholinergic muscaric receptors with the blockade of adrenergic alpha-receptors, and that its pressor response is revealed by stimulation of nicotinic receptors in autonomic ganglia.