Comparative Analysis between Multilevel Sectioning with Conventional Haematoxylin and Eosin Staining and Immunohistochemistry for Detecting Nodal Micrometastases with Stage I and II Colorectal Cancers

Wong, Yin-Ping; Shah, Shamsul Azhar; Shaari, Noorsajida; Esa, Mohd Shafbari Mohamad; Sagap, Ismail; Isa, Nurulhikma Md

doi:10.7314/apjcp.2014.15.4.1725

Cited by 6 publications

(6 citation statements)

References 26 publications

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“…In a study published by Isosaki et al, the LN, resected from111 patients submitted to radical gastrectomy were analyzed for the presence of metastases and micrometastases based on HE analysis and full sectioning of the LN, resulting in the assessment of 58,430 slides The authors concluded that, when comparing the diagnostic efficacy of LN metastases based on one section, three sections, and the entire LN sectioning, the three-sectioning method was the most cost-effective of all 21 . This finding was also reported by other authors, even in tumors of different primary sites 15,[22][23][24] .…”

Section: Discussionsupporting

confidence: 91%

“…Some authors propose just one cut, and others suggest the whole LN sectioning. This can impair the implementation of LN micrometastases search at pathology laboratories due to the work overload caused by this procedure [15][16][17][18] . In either way, when searching for LN micrometastases, it is recommended IHC using anti-cytokeratin antibodies as it increases the micrometastases detection rate 19,20 .…”

Section: Discussionmentioning

confidence: 99%

“…Other studies assessing the presence of micrometastases, not only in GC but also in colonic, esophageal, head and neck, and gynecological tumors, also observed the same findings. Such studies attest that, regardless of the tumor staging, the conventional histological evaluation, which is based on just one cut in the LN structure, does not stage the metastatic LN involvement adequately 13,15,16,25 .…”

Section: Discussionmentioning

confidence: 99%

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Impact of multisection and immunohistochemistry in lymph node staging of Gastric Carcinoma – Case series

Santos

Drummond-Lage

Wainstein

et al. 2020

Sci Rep

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Gastric carcinoma (GC) locoregional recurrence may occur even in cases where the tumor has been completely resected, possibly due to lymph node (LN) micrometastases. It is estimated that in 10% to 30% of cases, LN micrometastases are not detected by a conventional method for histological assessment of LN metastases with hematoxylin-eosin (HE). A cross-sectional study assessed 51 patients with GC by histological evaluation of the LN micrometastases through LN multi sectioning associated with immunohistochemistry analysis with monoclonal antibodies AE1 and AE3. Total gastrectomy was performed in 51% of patients. The total number of resected LN nodes was 1698, with a mean number of resected LN of 33.3 ± 13.2 per surgical specimen, of which 187 had metastasis. After the application of LN multisection and immunohistochemistry, LN micrometastases were found in 45.1% of the cases. LN staging changed in 29.4%, and tumor staging changed in 23.5% of the cases. In patients initially staged as pN0, LN staging and tumor staging changed, both in 19.2% of the cases. In patients initially staged as pN1 or more, LN staging changed in 40.0% of them, and tumor staging changed in 28.0% of the cases. The accuracy of HE for the histological staging of LN tumoral involvement was 76%, which was considered insufficient for CG patients staging. Investigation of LN micrometastasis through LN multisection and immunohistochemistry should be performed, particularly in cases where the presence of blood and lymphatic vessel invasion has been identified after conventional histological analysis, as well as in patients with advanced Gc. Gastric carcinoma (GC), despite the recent decrease observed in its incidence, remains the second most common cause of cancer death in the world, with more than 600,000 deaths per year. The main chance of cure of this neoplasm is on surgical resection. The standard procedure for the treatment of this condition is radical gastrectomy, which includes gastric resection with surgical margins free of neoplasia, associated with extended locoregional lymphadenectomy 1-3. Accurate tumor staging is one of the leading factors in the definition of the therapeutic strategy. From the exact knowledge of the extent of tumor dissemination, it is possible to define, with greater security, the best therapeutic approach for each patient, and, consequently, avoid incomplete or excessive treatments 4,5. Recent literature has discussed the role of lymph node (LN) micrometastasis in GC. Conceptually, micrometastases are metastases of sizes between 0.2 mm and 2.0 mm (5). Its incidence varies between 10% to 30% 6,7. Currently, many authors admit that its presence is associated with a worse prognosis and that the clinical behavior of these patients is like those with lymph node involvement by metastasis 8. In the submucosal GC (T1b), with the absence of LN metastases and micrometastases, the five-year survival rate is close to 100%, being significantly higher than in micrometastases positive cases (82%) 6. The presence of micrometastasis ma...

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Impact of multisection and immunohistochemistry in lymph node staging of Gastric Carcinoma – Case series

Santos

Drummond-Lage

Wainstein

et al. 2020

Sci Rep

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“…After cryoablation, the residual tumors become the origins of tumor recurrence and metastasis, and the important factors influencing the short-term efficacy of cryoablation. The recurrence and metastasis processes of residual tumors are complicated, including increased tumor proliferation activity, expressions of anti-apoptotic genes and angiogenesis factors, formation of angiogenesis as well as abnormal expressions of adhesion factors, multi-drug resistance genes and telomerase, etc., in which angiogenesis factor expression and angiogenesis formation exert considerable functions (Li et al, 2002;Diao et al, 2014;Erdogan et al, 2014;Madjd et al, 2014;Tang et al, 2014;Wong et al, 2014). The severity of tumor angiogenesis indirectly reflects the ability of tumor infiltration, recurrence and metastasis.…”

Section: Discussionmentioning

confidence: 99%

Experimental Study on Residual Tumor Angiogenesis after Cryoablation

Ma¹,

Jiang²,

Li³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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“…Известно, что у больных колоректальным раком II стадии вероятность рецидива составляет 20-30 %, при этом предполагается, что в лимфатических узлах у таких пациентов могут быть микрометастазы, которые не выявляются при обычном гистопатологическом исследовании [28]. Y. P. Wong и соавт.…”

Section: O N T a C T Sunclassified

Clinical significance of detection of micrometastases in lymph nodes in ovarian cancer

Aldushkina,

Anisimova,

Gritsai

et al. 2023

Rossijskij bioterapevtičeskij žurnal

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Ovarian cancer of epithelial origin is the most common type of oncological process in this organ and is characterized by a high probability of fatal outcome. It is believed that this is due to insufficiently effective diagnosis of the prevalence and severity of this disease. This review presents data on the development of disease recurrence in a significant number of patients after cytoreductive surgery. According to some authors, the reason for the high risk of recurrence is the insufficient information content of the method of studying histological preparations of regional lymph nodes after staining with hematoxylin and eosin to detect small-sized metastases, including isolated tumor cells and micrometastases. To improve the accuracy of such diagnostics, it is recommended to supplement the study of multilevel sections of lymph nodes using routine staining with the use of immunohistochemistry and other methods using various antibodies to cytokeratins, along with other epithelial markers. The review provides an analysis of the opinions of various researchers on the prognostic significance of the detection of micrometastases in the lymph nodes, which can increase the effectiveness of therapy due to a more accurate assessment of the prevalence of the disease and correction of the tactics of treating patients with various oncological diseases.

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Comparative Analysis between Multilevel Sectioning with Conventional Haematoxylin and Eosin Staining and Immunohistochemistry for Detecting Nodal Micrometastases with Stage I and II Colorectal Cancers

Cited by 6 publications

References 26 publications

Impact of multisection and immunohistochemistry in lymph node staging of Gastric Carcinoma – Case series

Impact of multisection and immunohistochemistry in lymph node staging of Gastric Carcinoma – Case series

Experimental Study on Residual Tumor Angiogenesis after Cryoablation

Clinical significance of detection of micrometastases in lymph nodes in ovarian cancer

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