High prevalence of isolated tumour cells in regional lymph nodes from pNO colorectal cancer

Mescoli, C.; Rugge, M.; Pucdarelli, S.; Russo, V. M.; Pennelli, G.; Guido, M.; Nitti, D.
August 2006
Journal of Clinical Pathology;Aug2006, Vol. 59 Issue 8, p870
Academic Journal
Background: The prevalence of isolated tumour cells (LTCs) in regional lymph nodes from colorectal cancer (CRC) is controversial and has never been prospectively assessed in large groups of consecutive patients. pN0 early-relapsing CRC can be explained by lymph node-ITC. Aim : To assess the prevalence of ITCs in regional lymph nodes from 309 consecutive patients with pN0MO (pathological (p)-tumour-node-metastasis (TNM) staging system) CRCs. Patients and methods: ITCs were assessed by immunohistochemistry (MNF1 16 monoclonal antibody (1:100); Dako, Glostrup, Denmark) in two serial histological sections obtained from 5016 mesenteric lymph nodes from 309 patients with pN0 CRCs (mean number of lymph nodes per patient= 16.2; p-TNM stage 0, n = 25; p-TNM stage I, n = 1 23; and p-TNM stage II (A+B), n = 161). Tumour histology, vascular cancer invasion and pathological stage were also recorded. Results: ITCs were detected in the regional lymph nodes of 156 of 309 (50.5%) patients with CRC, mostly in nodes located within 3 cm from the neoplasia. ITC status correlated with (a) tumour p-TNM stage (Pearson's χ2: p<0; ordered logistic regression: odds ratio (OR) = 4.6; 95% confidence interval (CI) = 2.88 to 7.33; p<0) and (b) pT value (Pearson's χ2: p = 0; ordered logistic regression: OR = 4.9; 95% CI = 3.1 to 7.7; p<0). By multivariate analysis, including p-TNM stage, vascular invasion and ITC status, both stage (OR = 5.1; 95% CI = 2.9 to 8.9; p


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