A pragmatic approach to the diagnosis of nodal micrometastases in early stage non-small cell lung cancer

• Verfasst von: Herpel, Esther [VerfasserIn]
• Verfasst von: Muley, Thomas [VerfasserIn]
• Verfasst von: Schneider, Thomas [VerfasserIn]
• Verfasst von: Palm, Elisa Maria [VerfasserIn]
• Verfasst von: Kieslich de Hol, Dörthe [VerfasserIn]
• Verfasst von: Warth, Arne [VerfasserIn]
• Verfasst von: Meister, Michael [VerfasserIn]
• Verfasst von: Storz, Konstantina [VerfasserIn]
• Verfasst von: Schnabel, Philipp Albert [VerfasserIn]
• Verfasst von: Schirmacher, Peter [VerfasserIn]
• Verfasst von: Dienemann, Hendrik [VerfasserIn]
• Verfasst von: Hoffmann, Hans [VerfasserIn]
• Titel: A pragmatic approach to the diagnosis of nodal micrometastases in early stage non-small cell lung cancer
• Verf.angabe: Esther Herpel, Thomas Muley, Thomas Schneider, Elisa Palm, Dörthe Kieslich de Hol, Arne Warth, Michael Meister, Konstantina Storz, Philipp A. Schnabel, Peter Schirmacher, Hendrik Dienemann, and Hans Hoffmann
• E-Jahr: 2010
• Jahr: [August 2010]
• Umfang: 7 S.
• Illustrationen: Diagramme
• Fussnoten: Elektronische Reproduktion der Druckausgabe ; Gesehen am 26.04.2023
• Titel Quelle: Enthalten in: Journal of thoracic oncology
• Ort Quelle: Amsterdam : Elsevier, 2006
• Jahr Quelle: 2010
• Band/Heft Quelle: 5(2010), 8 vom: Aug., Seite 1206-1212
• ISSN Quelle: 1556-1380
• DOI: doi:10.1097/JTO.0b013e3181e15cfd
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Immunohistochemistry
• Sach-SW: Lung cancer
• Sach-SW: Lymph node
• Sach-SW: Micrometastases
• Sach-SW: Prognostic impact
• K10plus-PPN: 1843594250

Abstract

Introduction - This study was designed to develop a both sensitive and efficient algorithm for detection of lymph node micrometastases and to determine its prognostic impact in patients with early stage non-small cell lung cancer (NSCLC). - Methods - One hundred seventy patients with NSCLC p stage I and II were included in this study, of which n = 5299 lymph nodes were obtained and submitted to histopathologic analysis. From each patient, a median number of 31 lymph nodes was received (N-1 position: median n = 16; N-2 position: median n = 15). Immunohistochemistry was performed to detect micrometastases unobvious by conventional microscopy using antibodies against cytokeratins (CK) (pan-CK: KL-1, CK 5/6, CK 7) and the epithelial marker Ber-EP4. - Results - In 82 patients (48.2%), micrometastases were revealed in immunohistochemistry staining. KL-1 detected micrometastases in 201 (99.5%) of 202 positive lymph nodes. Subsequently, this resulted in an upstaging in 39 patients (20.5%). Detection of micrometastases in otherwise tumor-free N2-lymph nodes had a significant prognostic impact (mean disease-free survival 21.4 versus 45.3 months, p = 0.022), affecting 4.7% of patients. Survival differences between patients who were upstaged into stage II (N0>N1) and those remaining in stage I were not statistically significant (p = 0.537). - Conclusion - Extended workup of N2-lymph nodes using one broad-spectrum keratin marker in otherwise N2-negative lymph nodes may represent a both efficient and sensitive approach to the identification of micrometastases in dissected lymph nodes of patients with early stage NSCLC.