Nakamura Tsutomu, Ide Hiroko, Eguchi Reiki, Hayashi Kazuhiko, Ota Masaho, Takasaki Ken
Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan.
J Surg Oncol. 2002 Apr;79(4):224-9. doi: 10.1002/jso.10080.
Lymph node micrometastasis is frequently detected in resected specimens of esophageal squamous cell carcinoma (ESCC). The goal of this study was to evaluate the clinical implication of micrometastasis in patients with lymph node-negative (pN0) disease.
We examined the presence of micrometastasis in 2,511 lymph nodes from 53 patients with pN0 disease who underwent curative esophagectomy. All lymph nodes and the primary tumors were immunostained using an anticytokeratin antibody cocktail (AE1/AE3).
Micrometastasis was detected in 18 lymph nodes (0.72%) from 14 patients (26.4%). Detection of micrometastasis was not associated with the depth of invasion or the differentiation or lymphatic invasion. Lymph nodes containing micrometastases were widely distributed, but the most frequently involved nodes were located along the lesser curvature of the stomach. Four patients with micrometastasis (29%) and the only two patients without micrometastasis (5%) had recurrence as lymph node metastases (P = 0.036). There were no significant differences in recurrence-free survival and disease-specific survival between patients with micrometastasis and patients without micrometastasis.
These results show that micrometastasis might increase the risk of lymph node recurrence, but does not influence the survival of patients with pN0 ESCC.
在食管鳞状细胞癌（ESCC）切除标本中经常检测到淋巴结微转移。本研究的目的是评估微转移在淋巴结阴性（pN0）疾病患者中的临床意义。
我们检查了53例接受根治性食管切除术的pN0疾病患者的2511个淋巴结中微转移的存在情况。所有淋巴结和原发肿瘤均使用抗细胞角蛋白抗体混合物（AE1/AE3）进行免疫染色。
在14例患者（26.4%）的18个淋巴结（0.72%）中检测到微转移。微转移的检测与浸润深度、分化程度或淋巴浸润无关。含有微转移的淋巴结分布广泛，但最常受累的淋巴结位于胃小弯处。4例有微转移的患者（29%）和仅2例无微转移的患者（5%）发生了作为淋巴结转移的复发（P = 0.036）。有微转移的患者和无微转移患者的无复发生存率和疾病特异性生存率没有显著差异。
这些结果表明，微转移可能会增加淋巴结复发的风险，但不影响pN0 ESCC患者的生存。
