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. 2008 May 30;27(1):7.
doi: 10.1186/1756-9966-27-7.

Detection of sentinel and non-sentinel lymph node micrometastases by complete serial sectioning and immunohistochemical analysis for gastric cancer

Kaname Ishii  1 , Shinichi Kinami, Kenichiro Funaki, Hideto Fujita, Itasu Ninomiya, Sachio Fushida, Takashi Fujimura, Genichi Nishimura, Masato Kayahara
Affiliations

Detection of sentinel and non-sentinel lymph node micrometastases by complete serial sectioning and immunohistochemical analysis for gastric cancer

Kaname Ishii et al. J Exp Clin Cancer Res. .

Abstract

Background: We investigated the presence and distribution of the sentinel and the non-sentinel node micrometastases using complete serial sectioning and immunohistochemical staining (IHC), to inspect whether lymph node micrometastases spread to the sentinel lymph nodes first.

Methods: A total of 35 patients, who underwent gastrectomy with a sentinel lymph node biopsy for gastric cancer, were enrolled in this study. Total of 1028 lymph nodes of 35 patients having gastric cancer without metastasis of lymph node by permanent section with hematoxylin and eosin staining (H&E) were selected. There were 252 sentinel nodes and the other 776 were non-sentinel nodes. All nodes were sectioned serially and stained alternately with H&E and IHC. Lymph node micrometastases was defined as proving to be positive first either the IHC or the complete serial sectioning.

Results: Micrometastases were detected in 4 (11%) of the 35 patients, 6 (0.58%) of 1028 nodes. Of these 4 patients, 3 had micrometastases exclusively in sentinel nodes, and the other had micrometastasis in both sentinel and non-sentinel nodes. There was no patient who had the micrometastases only in non-sentinel nodes.

Conclusion: These results support the concept that lymph node micrometastasis of gastric cancer spreads first to sentinel nodes.

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Figures

Figure 1
Figure 1
Lymph node mircrometastasis as detected by immunohistochemical staining with a cytokeratin antibody. (×400).
Figure 2
Figure 2
No cancer cells were identified in this section by routine histologic examination. (hematoxylin & eosin staining, ×40). (b) Lymph node micrometastasis in the representative section by the entire serial sectioning method. (Immunohistochemical staining, ×40). (c) Micrometastasis lymph node in the representative section by the entire serial sectioning method. (Immunohistochemical staining, ×400)
See this image and copyright information in PMC

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