doiSerbia

Prevalence and importance of nodal micrometastasis in patients with gastric adenocarcinoma

Bjelović Miloš (Centar za hirurgiju jednjaka, Institut za bolesti digestivnog sistema, Klinički centar Srbije, Beograd)
Peško Predrag (Centar za hirurgiju jednjaka, Institut za bolesti digestivnog sistema, Klinički centar Srbije, Beograd)
Micev Marjan (Odeljenje za patološku histologiju, Institut za bolesti digestivnog sistema, Klinički centar Srbije, Beograd; Laboratorija za imunohistohemiju i elektronsku mikroskopiju, Institut za medicinska istraživanja, Beograd)
Todorović Vera N. (Laboratorija za imunohistohemiju i elektronsku mikroskopiju, Institut za medicinska istraživanja, Beograd)
Trajković Goran (Institut za statistiku i medicinsku informatiku, Medicinski fakultet, Kosovska Mitrovica)
Stojakov Dejan (Centar za hirurgiju jednjaka, Institut za bolesti digestivnog sistema, Klinički centar Srbije, Beograd)
Sabljak Predrag (Centar za hirurgiju jednjaka, Institut za bolesti digestivnog sistema, Klinički centar Srbije, Beograd)

Micrometastasis is a microscopic (less than 2 mm) deposit of malignant cells separated from the primary tumor. The incidence and importance of occult perigastric lymph node involvement were analyzed in 26 pNO patients using the prospective method. The occult lymph node involvement was detected by immunohistochemical method using the anticyto-keratin 8/18 antibody. Prevalence of clinically significant occult lymph node involvement (Mi+) was statistically significant, and found in 38.5% of pNO patients. Out of tumor characteristics analyzed as possible predictors of occult lymph node involvement, the histological grade (GH) and the involvement of lymphatic vessels within gastric wall (pLl) had significant effect on the respective evaluation. The patients with histological grade 3 and 4 had occult lymph node involvement more often than those with grade 1 and 2 (p<0.05). More than 60% of pL1 patients had occult lymph node involvement LN (Mi+). Due to high prevalence of micrometastatic lymph node involvement, detection with specific immunohistochemical or molecular biology techniques should be a part of routine specimen examination in patients with pNO gastric cancer.

Keywords: adenocarcinoma, stomach, lymph nodes, micrometastasis