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Lymphatic invasion using D2-40 monoclonal antibody and its relationship to lymph node micrometastasis in pN0 gastric cancer.

Arigami T, Natsugoe S, Uenosono Y, Arima H, Mataki Y, Ehi K, Yanagida S, Ishigami S, Hokita S, Aikou T - Br. J. Cancer (2005)

Bottom Line: Although haematoxylin-eosin (HE) staining revealed lymphatic invasion in 11.3% (nine out of 80) of patients, D2-40 staining uncovered new invasion in 23.8% (19 out of 80) of patients.In the diagnosis of HE and D2-40 staining, the incidence of micrometastasis was significantly higher in patients with lymphatic invasion than in those without lymphatic invasion (P=0.0150 and P<0.0001, respectively).Micrometastasis correlated more closely with D2-40 than with HE staining.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgical Oncology and Digestive Surgery, Field of Oncology, Course of Advanced Therapeutics, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima 890-8520, Japan. arigami@m.kufm.kagoshima-u.ac.jp

ABSTRACT
The monoclonal antibody D2-40 is a specific lymphatic endothelial markers and D2-40 staining have been applicable to evaluate lymphatic invasion in various malignant neoplasms. In the present study, we investigated lymph node micrometastasis determined by immunohistochemistry (IHC) and reverse transcription-polymerase chain reaction (RT-PCR) in all dissected lymph nodes obtained from 80 patients with node-negative gastric cancer, and analysed the relationship between micrometastasis and clinicopathological findings including lymphatic invasion of the resected primary tumour using D2-40 immunohistochemical staining. The incidence of micrometastasis determined by IHC and RT-PCR was 11.3% (nine out of 80) and 31.3% (25 out of 80), respectively. Although haematoxylin-eosin (HE) staining revealed lymphatic invasion in 11.3% (nine out of 80) of patients, D2-40 staining uncovered new invasion in 23.8% (19 out of 80) of patients. In the diagnosis of HE and D2-40 staining, the incidence of micrometastasis was significantly higher in patients with lymphatic invasion than in those without lymphatic invasion (P=0.0150 and P<0.0001, respectively). Micrometastasis correlated more closely with D2-40 than with HE staining. We demonstrated a high incidence of micrometastasis and lymphatic invasion and a correlation between them even in pN0 gastric cancer. When planning less invasive treatment, the presence of such occult cancer cells should be considered.

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Example of a patient diagnosed as being free of lymphatic invasion by routine histological examination. (A) Routine haematoxylin–eosin staining. (B) D2-40 staining. (C) Cytokeratin (AE1/AE3) staining. Original magnification × 400.
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fig2: Example of a patient diagnosed as being free of lymphatic invasion by routine histological examination. (A) Routine haematoxylin–eosin staining. (B) D2-40 staining. (C) Cytokeratin (AE1/AE3) staining. Original magnification × 400.

Mentions: Lymphatic vessels were clearly delineated by D2-40 staining (Figure 2). The patient described in this figure had a pT2 tumour that routine histological examination had determined was pN0 and free of lymphatic invasion (Figure 2A). However, D2-40 staining revealed obvious lymphatic invasion (Figure 2B). A single cancer cell was identified by CK immunohistochemical staining in this lymphatic vessel (Figure 2C). Some lymphatic vessels that were HE negative were obviously positive according to D2-40 staining (Figure 2). Histological HE staining revealed lymphatic invasion from the primary tumour in nine of the 80 patients (11.3%, Figure 3). In eight of these nine, lymphatic invasion detected by HE staining was in accord with the results of D2-40 staining. On the other hand, lymphatic invasion was newly detected in 11 (13.8%) patients who were diagnosed as free of lymphatic invasion by HE staining. Thus, the incidence of lymphatic invasion increased from 11.3% by HE staining to 23.8% by D2-40 staining.


Lymphatic invasion using D2-40 monoclonal antibody and its relationship to lymph node micrometastasis in pN0 gastric cancer.

Arigami T, Natsugoe S, Uenosono Y, Arima H, Mataki Y, Ehi K, Yanagida S, Ishigami S, Hokita S, Aikou T - Br. J. Cancer (2005)

Example of a patient diagnosed as being free of lymphatic invasion by routine histological examination. (A) Routine haematoxylin–eosin staining. (B) D2-40 staining. (C) Cytokeratin (AE1/AE3) staining. Original magnification × 400.
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Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2361610&req=5

fig2: Example of a patient diagnosed as being free of lymphatic invasion by routine histological examination. (A) Routine haematoxylin–eosin staining. (B) D2-40 staining. (C) Cytokeratin (AE1/AE3) staining. Original magnification × 400.
Mentions: Lymphatic vessels were clearly delineated by D2-40 staining (Figure 2). The patient described in this figure had a pT2 tumour that routine histological examination had determined was pN0 and free of lymphatic invasion (Figure 2A). However, D2-40 staining revealed obvious lymphatic invasion (Figure 2B). A single cancer cell was identified by CK immunohistochemical staining in this lymphatic vessel (Figure 2C). Some lymphatic vessels that were HE negative were obviously positive according to D2-40 staining (Figure 2). Histological HE staining revealed lymphatic invasion from the primary tumour in nine of the 80 patients (11.3%, Figure 3). In eight of these nine, lymphatic invasion detected by HE staining was in accord with the results of D2-40 staining. On the other hand, lymphatic invasion was newly detected in 11 (13.8%) patients who were diagnosed as free of lymphatic invasion by HE staining. Thus, the incidence of lymphatic invasion increased from 11.3% by HE staining to 23.8% by D2-40 staining.

Bottom Line: Although haematoxylin-eosin (HE) staining revealed lymphatic invasion in 11.3% (nine out of 80) of patients, D2-40 staining uncovered new invasion in 23.8% (19 out of 80) of patients.In the diagnosis of HE and D2-40 staining, the incidence of micrometastasis was significantly higher in patients with lymphatic invasion than in those without lymphatic invasion (P=0.0150 and P<0.0001, respectively).Micrometastasis correlated more closely with D2-40 than with HE staining.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgical Oncology and Digestive Surgery, Field of Oncology, Course of Advanced Therapeutics, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima 890-8520, Japan. arigami@m.kufm.kagoshima-u.ac.jp

ABSTRACT
The monoclonal antibody D2-40 is a specific lymphatic endothelial markers and D2-40 staining have been applicable to evaluate lymphatic invasion in various malignant neoplasms. In the present study, we investigated lymph node micrometastasis determined by immunohistochemistry (IHC) and reverse transcription-polymerase chain reaction (RT-PCR) in all dissected lymph nodes obtained from 80 patients with node-negative gastric cancer, and analysed the relationship between micrometastasis and clinicopathological findings including lymphatic invasion of the resected primary tumour using D2-40 immunohistochemical staining. The incidence of micrometastasis determined by IHC and RT-PCR was 11.3% (nine out of 80) and 31.3% (25 out of 80), respectively. Although haematoxylin-eosin (HE) staining revealed lymphatic invasion in 11.3% (nine out of 80) of patients, D2-40 staining uncovered new invasion in 23.8% (19 out of 80) of patients. In the diagnosis of HE and D2-40 staining, the incidence of micrometastasis was significantly higher in patients with lymphatic invasion than in those without lymphatic invasion (P=0.0150 and P<0.0001, respectively). Micrometastasis correlated more closely with D2-40 than with HE staining. We demonstrated a high incidence of micrometastasis and lymphatic invasion and a correlation between them even in pN0 gastric cancer. When planning less invasive treatment, the presence of such occult cancer cells should be considered.

Show MeSH
Related in: MedlinePlus