Intrinsic variability in the detection of micrometastases in lymph nodes for re-staging of colorectal cancer

Salto-Tellez, Manuel; Kong, Shan; Leong, A. P. K.; Koay, Evelyn S C

doi:10.1016/s0959-8049(03)00231-4

Cited by 6 publications

(4 citation statements)

References 20 publications

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“…Das zu erwartende Problem dabei ist derzeit bei hoher Sensitivität eine noch niedrige Spezifität, die u. a. durch unspezifischen Antigennachweis infolge von Verunreinigungen bei der Präparation [54], degenerierte bzw. prozessierte Tumorantigene in Lymphknoten [56] oder Unterschiede in der Gewebeasservationstechnik hervorgerufen werden kann [57].…”

Section: Sln-aufarbeitungunclassified

Optimierung des Staging beim Kolonkarzinom durch Sentinel-Lymphknoten-Biopsie

Bembenek

Schneider

Gretschel

et al. 2005

Chirurg

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Routine determination of the nodal status in colon cancer is strongly dependent on the individual quality and technique of histopathological assessment and surgical lymph node dissection. We evaluated whether sentinel lymph node biopsy (SLNB) could contribute to an improvement in staging. At least one SLN (median n=2) was detected (detection rate 84%) in each of 38 of 45 patients with primary colon cancer. Ten of these 38 were found to have lymph node metastases by HE staining (26%), six of them in the SLN. Nine of the 28 patients that were initially nodal-negative by HE revealed one micrometastasis and eight cases of isolated tumor cells by immunohistochemical (IHC) staining (32% upstaging response). Including the IHC-positive cases, 19 of the 38 patients were nodal-positive (50%), 15 of them with tumor-infiltrated SLN (overall sensitivity of SLNB 79%). Using the dye method, SLNB is clinically practicable and leads in the majority of the patients to the detection of SLN. The selective, intensified histopathological assessment of SLN identifies small tumor cell deposits in a relevant percentage of patients with little and clinically practicable effort.

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Section: Sln-aufarbeitungunclassified

Optimierung des Staging beim Kolonkarzinom durch Sentinel-Lymphknoten-Biopsie

Bembenek

Schneider

Gretschel

et al. 2005

Chirurg

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“…7 Briefly, we studied a total of 220 LNs from 28 consecutive patients with CRC (two Dukes' A, 11 Dukes' B, 15 Dukes' C) from our diagnostic routine workload. The nodes were sampled in the fresh state immediately after surgery.…”

Section: Patients and Tissuesmentioning

confidence: 99%

“…7 [16][17][18] Template cDNA (1 ml) was added to the reaction mixture (LightCycler FastStart DNA Master SYBR Green I; Roche Diagnostics GmbH, Mannheim, Germany), which contained FastStart Taq DNA polymerase, reaction buffer, dNTP mix (with dUTP instead of dTTP), SYBR Green I dye, FastStart enzyme, and 3 mmol/litre MgCl 2 for the CEA and GCC reaction or 4 mmol/litre MgCl 2 for the CK20 reaction.…”

Section: Rt-pcrmentioning

confidence: 99%

“…However, we have shown how the intrinsic variability in the applied methodology has prevented meaningful comparison of the results from different laboratories. 7 Arguably, the use of quantitative real time PCR (R-PCR) may help to resolve these problems by providing a more sensitive, reliable, and measurable detection of disseminated cancer cells in CRC, because R-PCR has several advantages over other traditional PCR strategies. [8][9][10] In the R-PCR system, mRNA expression is quantified during the logarithmic phase of PCR amplification, which provides a more reliable method of gene quantification.…”

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confidence: 99%

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Discordant quantitative detection of putative biomarkers in nodal micrometastases of colorectal cancer: biological and clinical implications

Kong

2005

J Clin Pathol

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Aims:Nodal expression of the carcinoembryonic antigen (CEA), cytokeratin 20 (CK20), and guanylyl cyclase C (GCC) genes was measured in tandem in patients with colorectal cancer (CRC) to assess whether there would be sufficient agreement between these markers in their ability to detect micrometastasis to qualify one of them as a universal marker, and whether frozen and paraffin wax embedded tissues would yield similar results.Methods:One hundred and seventy five frozen lymph nodes (FT) and 158 formalin fixed, paraffin wax embedded lymph nodes (PET) from 28 CRC cases were analysed using gene specific quantitative real time polymerase chain reaction, carried out on the LightCycler® system with SYBR Green chemistry.Results:There was significant disparity in positive detection of the three biomarkers in FT versus PET, with notable agreement achieved only for CEA (66.6%) in FT versus PET in Dukes’ B disease, and between CK20 and GCC (44.6%) in FT, also in Dukes’ B disease. One patient with full concordance in all three tumour markers with both tissue types suffered a relapse and died within two years of follow up.Conclusions:There was considerable discordance in the positive detection of the three tumour markers in both tissue types (FT versus PET). This brings into question whether using a single tumour marker to detect micrometastasis in one tissue type (FT or PET) is adequately representative, and challenges the concept of universal markers for molecular CRC metastatic detection. Multiple tumour markers would predict more accurately the metastatic potential of Dukes’ B CRCs.

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