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Cytokeratin staining of resected lymph nodes may improve the sensitivity of surgical staging for endometrial cancer.

Abstract：

OBJECTIVE:The presence of metastases to regional lymph nodes (LN) is the single most important risk factor in endometrial cancer. Advances in molecular biology have provided more sensitive methods for detecting micrometastasis. This was a pilot study to determine whether cytokeratin staining of LN from endometrial cancer patients is more sensitive than traditional histopathologic evaluation for the detection of micrometastasis. METHODS:The inclusion criteria included patients with surgical stage I-II endometrial cancer having >50% myometrial invasion, lesions >2 cm, and negative LN together with one of the following: FIGO grade 3 or cervical or lymph-vascular involvement. A matched control group included patients with LN metastasis. The evaluation of the LN at the time of initial surgery consisted of a frozen section and a reevaluation on permanent sections with H&E. In the study, lymphadenectomy specimens were cut, stained again with H&E and with cytokeratin, and examined. Cytokeratin staining was performed with AE1/AE3 antibodies. There were 16 LN-negative cases and 9 LN-positive controls. RESULTS:There was complete agreement between the LN assessment at time of surgery and the study H&E review prior to the staining for cytokeratin. However, 2 LN-negative cases (12.5%) had micrometastasis by cytokeratin staining. One of these patients developed recurrent disease in the para-aortic LN and died of disease at 2.8 years. CONCLUSION:Cytokeratin staining may improve the sensitivity for detection of metastasis compared to traditional evaluation. This study strongly suggests that these micrometastasis are clinically significant. An approach incorporating cytokeratin analysis could improve the risk assessment of specific patients.

journal_name

Gynecol Oncol

journal_title

Gynecologic oncology

authors

Gonzalez Bosquet J,Keeney GL,Mariani A,Webb MJ,Cliby WA

doi

10.1016/j.ygyno.2003.08.026

subject

Has Abstract

pub_date

2003-12-01 00:00:00

pages

518-25

issue

3

eissn

0090-8258

issn

1095-6859

pii

S0090825803005882

journal_volume

91

pub_type

杂志文章

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