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결장 및 직장암에서 면역조직화학 염색으로 발견된 림프절 유리 암세포의 의의

The Prognostic Significance of Immunohistochemically Detected Isolated Tumor Cells in Lymph Node in Colorectal Cancer

대한대장항문학회지 2002년 18권 5호 p.317 ~ 323
이진석 ( Lee Jin-Suk ) - 경상대학교 의과대학 외과학교실

임정우 ( Lim Jung-Woo ) - 경상대학교 의과대학 외과학교실
최상경 ( Choi Sang-Kyeong ) - 경상대학교 의과대학 외과학교실
정은정 ( Jung Eun-Jung ) - 경상대학교 의과대학 외과학교실
이영준 ( Lee Young-Joon ) - 경상대학교 의과대학 외과학교실
홍순찬 ( Hong Soon-Chan ) - 경상대학교 의과대학 외과학교실
권수인 ( Kwon Soo-In ) - 경상대학교 의과대학 외과학교실
박순태 ( Park Soon-Tae ) - 경상대학교 의과대학 외과학교실
하우송 ( Ha Woo-Song ) - 경상대학교 의과대학 외과학교실

Abstract


Purpose:Metastasis of a colorectal carcinoma to regional lymph nodes indicates poor prognosis. The detection of lymph node metastasis is routinely performed by histopathological analysis of hematoxylin-eosin (H&E) stained sections.
However the routine histological technique may fail to detect isolated tumor cells in lymph nodes. The aims of this study are to elucidate the prognostic significance of the presence of isolated tumor cells in the regional lymph nodes in colorectal cancer, and to elucidate the correlation between the presence of isolated tumor cells and p53 protein expression in the primary colorectal cancer tissue.

Methods:We used immunohistochemical staining with anti-cytokeratin antibody to examine 452 lymph nodes in 24 patients (11 recurrent and 13 nonrecurrent) who were histologically determined Astler-Coller B. And we used immunohistochemical staining with p53 protein to examine primary colorectal cancer tissues of the patients.

Results:Immunohistochemical staining of cytokeratin revealed the presence of isolated tumor cells in 5/13 patients (38.5%), 5/214 lymph nodes (2.34%) in the nonrecurrent group and 6/11 patients (54.6%), 11/244 lymph nodes (4.51%) in the recurrent group, respectively. The detection rate of isolated tumor cells in the recurrent group was slightly higher than nonrecurrent group, but the difference was not significant statistically. The expression rate of p53 protein was 23.1% (3/13) in the nonrecurrent group and 36.4% (4/11) in the recurrent group, respectively. The expression rate of the p53 protein was not significantly correlated with the presence of isolated tumor cells in regional lymph nodes and the rate of tumor recurrence.

Conclusions: The presence of isolated tumor cells in regional lymph nodes was not a prognostic indicator in predicting recurrence in histologically determined Astler- Collar B colorectal cancer patients.

키워드

유리 암세포;사이토케라틴;결직장암;p53 단백발현
Isolated tumor cell;Cytokeratin;Colorectal cancer;p53 protein expression
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