Division of Anatomical Pathology, Department of Pathology, Queen Elizabeth II Health Sciences Centre and Dalhousie University, Halifax, Nova Scotia, Canada B3H 1V8.
Hum Pathol. 2012 Aug;43(8):1258-64. doi: 10.1016/j.humpath.2011.10.002. Epub 2012 Feb 2.
The relationship between higher total lymph node resection number in colorectal cancer resection specimens and improved overall survival is well known. Recent studies describe an association between a high rate of microsatellite instability and a high total lymph node count in colorectal cancer. Higher lymph node retrieval may potentially explain the improved survival seen in cancers with microsatellite instability. We investigate whether these associations can be validated in a cohort of American Joint Committee on Cancer stage III colon cancers. Medical records from 200 cases of stage III colon cancer resection specimens were reviewed, and sufficient tissue was available for 168. Expression of DNA mismatch repair proteins was determined by immunohistochemistry, and microsatellite status, by polymerase chain reaction. The mean total lymph node count in cases with microsatellite instability versus microsatellite stable tumors (15.9 versus 16.9; P = .664) and the mean number of negative lymph nodes in each respective category (12.2 versus 13.6; P = .522) were not significantly different. There was no difference between microsatellite stable cases and cases with microsatellite instability when total lymph node counts (P = .953) or negative lymph node counts (P = .381) were analyzed with respect to percentage of cases above and below the medians. This cohort of stage III colon cancers does not support a significant relationship between microsatellite status and a higher retrieval of total or negative lymph nodes. Although microsatellite instability is associated with improved overall survival in our cohort (P = .026), the reason for this does not appear to be related to higher numbers of retrieved lymph nodes.
众所周知，结直肠癌切除标本中总淋巴结切除数量较高与总生存期改善之间存在关系。最近的研究描述了结直肠癌中微卫星不稳定性高率与总淋巴结计数高之间的关联。较高的淋巴结检出率可能可以解释微卫星不稳定的癌症中观察到的生存改善。我们调查这些关联是否可以在一组美国癌症联合委员会（AJCC）III 期结肠癌中得到验证。回顾了 200 例 III 期结肠癌切除标本的病历记录，其中 168 例有足够的组织。通过免疫组织化学测定 DNA 错配修复蛋白的表达，通过聚合酶链反应测定微卫星状态。微卫星不稳定与微卫星稳定肿瘤的平均总淋巴结计数（15.9 对 16.9；P=.664）和每个相应类别的平均阴性淋巴结数（12.2 对 13.6；P=.522）无显着差异。微卫星稳定病例和微卫星不稳定病例之间的总淋巴结计数（P=.953）或阴性淋巴结计数（P=.381）在分析中位数以上和以下病例的百分比时没有差异。这组 III 期结肠癌不支持微卫星状态与总或阴性淋巴结较高检出率之间存在显着关系。尽管微卫星不稳定性与我们队列中的总体生存改善相关（P=.026），但原因似乎与检出的淋巴结数量增加无关。
