Immunohistochemistry analysis of micrometastasis in pretreatment lymph nodes from patients with esophageal cancer

Xiaolong Jiao, Afshin Eslami, Olga Ioffe, King F. Kwong, Michael Henry, Qingling Zeng, Yael Refaely, Whitney Burrows, Ziv Gamliel, Mark J. Krasna, Joseph I. Miller, Stephen D. Cassivi

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Background. With recent advances in neoadjuvant therapy in esophageal cancer, pretreatment lymph node staging has become increasingly important in stratifying patients to appropriate treatment regimens and for prognostication. Immunohistochemical analysis (IHC) using epithelial markers has been shown to identify micrometastases in histologically negative lymph nodes. We performed this study to evaluate if IHC analysis in thoracoscopic/laparoscopic (Ts/Ls) pretreatment staging lymph nodes can reveal additional diagnostic information to routine histopathology. Methods. Specimens of 106 patients with esophageal cancer who had pretreatment Ts/Ls staging were retrospectively studied. Lymph node biopsies were obtained for IHC staining using cytokeratin (CK) of AE1/AE3. IHC staining for p53, an apoptosis protein associated with poor prognosis in esophageal cancer, was also performed. Results. 331 Ts/Ls staging lymph node biopsies were collected from 106 patients. A total of 15.4% (51/331) of the lymph nodes or 34.9% (37/106) of patients were found to have metastatic deposits by routine histology. All the histologically positive lymph nodes were CK positive. Among the remaining 280 histologically negative lymph nodes, 11(3.9%) were found to have micrometastasis by CK staining. Three patients (4.3%, 3/69) were upstaged from N0 to N1. They died of early recurrences after treatment. A total of 67.6% (25/37) of the patients with histologically positive lymph node were p53 positive. No histologically negative lymph node was found to be p53 positive in this series. Conclusions. Immunohistochemical analysis for CK can detect micrometastatic involvement of lymph nodes that are missed on routine pathologic examination, and, therefore, can improve lymph node staging. Its clinical significance in esophageal cancer warrants further study.

Original languageEnglish (US)
Pages (from-to)996-1000
Number of pages5
JournalAnnals of Thoracic Surgery
Volume76
Issue number4
DOIs
StatePublished - Oct 1 2003
Externally publishedYes

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Neoplasm Micrometastasis
Esophageal Neoplasms
Lymph Nodes
Immunohistochemistry
Keratins
Staining and Labeling
Biopsy
Neoadjuvant Therapy
Histology

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Immunohistochemistry analysis of micrometastasis in pretreatment lymph nodes from patients with esophageal cancer. / Jiao, Xiaolong; Eslami, Afshin; Ioffe, Olga; Kwong, King F.; Henry, Michael; Zeng, Qingling; Refaely, Yael; Burrows, Whitney; Gamliel, Ziv; Krasna, Mark J.; Miller, Joseph I.; Cassivi, Stephen D.

In: Annals of Thoracic Surgery, Vol. 76, No. 4, 01.10.2003, p. 996-1000.

Research output: Contribution to journalArticle

Jiao, X, Eslami, A, Ioffe, O, Kwong, KF, Henry, M, Zeng, Q, Refaely, Y, Burrows, W, Gamliel, Z, Krasna, MJ, Miller, JI & Cassivi, SD 2003, 'Immunohistochemistry analysis of micrometastasis in pretreatment lymph nodes from patients with esophageal cancer', Annals of Thoracic Surgery, vol. 76, no. 4, pp. 996-1000. https://doi.org/10.1016/S0003-4975(03)00658-1
Jiao, Xiaolong ; Eslami, Afshin ; Ioffe, Olga ; Kwong, King F. ; Henry, Michael ; Zeng, Qingling ; Refaely, Yael ; Burrows, Whitney ; Gamliel, Ziv ; Krasna, Mark J. ; Miller, Joseph I. ; Cassivi, Stephen D. / Immunohistochemistry analysis of micrometastasis in pretreatment lymph nodes from patients with esophageal cancer. In: Annals of Thoracic Surgery. 2003 ; Vol. 76, No. 4. pp. 996-1000.
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abstract = "Background. With recent advances in neoadjuvant therapy in esophageal cancer, pretreatment lymph node staging has become increasingly important in stratifying patients to appropriate treatment regimens and for prognostication. Immunohistochemical analysis (IHC) using epithelial markers has been shown to identify micrometastases in histologically negative lymph nodes. We performed this study to evaluate if IHC analysis in thoracoscopic/laparoscopic (Ts/Ls) pretreatment staging lymph nodes can reveal additional diagnostic information to routine histopathology. Methods. Specimens of 106 patients with esophageal cancer who had pretreatment Ts/Ls staging were retrospectively studied. Lymph node biopsies were obtained for IHC staining using cytokeratin (CK) of AE1/AE3. IHC staining for p53, an apoptosis protein associated with poor prognosis in esophageal cancer, was also performed. Results. 331 Ts/Ls staging lymph node biopsies were collected from 106 patients. A total of 15.4{\%} (51/331) of the lymph nodes or 34.9{\%} (37/106) of patients were found to have metastatic deposits by routine histology. All the histologically positive lymph nodes were CK positive. Among the remaining 280 histologically negative lymph nodes, 11(3.9{\%}) were found to have micrometastasis by CK staining. Three patients (4.3{\%}, 3/69) were upstaged from N0 to N1. They died of early recurrences after treatment. A total of 67.6{\%} (25/37) of the patients with histologically positive lymph node were p53 positive. No histologically negative lymph node was found to be p53 positive in this series. Conclusions. Immunohistochemical analysis for CK can detect micrometastatic involvement of lymph nodes that are missed on routine pathologic examination, and, therefore, can improve lymph node staging. Its clinical significance in esophageal cancer warrants further study.",
author = "Xiaolong Jiao and Afshin Eslami and Olga Ioffe and Kwong, {King F.} and Michael Henry and Qingling Zeng and Yael Refaely and Whitney Burrows and Ziv Gamliel and Krasna, {Mark J.} and Miller, {Joseph I.} and Cassivi, {Stephen D.}",
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T1 - Immunohistochemistry analysis of micrometastasis in pretreatment lymph nodes from patients with esophageal cancer

AU - Jiao, Xiaolong

AU - Eslami, Afshin

AU - Ioffe, Olga

AU - Kwong, King F.

AU - Henry, Michael

AU - Zeng, Qingling

AU - Refaely, Yael

AU - Burrows, Whitney

AU - Gamliel, Ziv

AU - Krasna, Mark J.

AU - Miller, Joseph I.

AU - Cassivi, Stephen D.

PY - 2003/10/1

Y1 - 2003/10/1

N2 - Background. With recent advances in neoadjuvant therapy in esophageal cancer, pretreatment lymph node staging has become increasingly important in stratifying patients to appropriate treatment regimens and for prognostication. Immunohistochemical analysis (IHC) using epithelial markers has been shown to identify micrometastases in histologically negative lymph nodes. We performed this study to evaluate if IHC analysis in thoracoscopic/laparoscopic (Ts/Ls) pretreatment staging lymph nodes can reveal additional diagnostic information to routine histopathology. Methods. Specimens of 106 patients with esophageal cancer who had pretreatment Ts/Ls staging were retrospectively studied. Lymph node biopsies were obtained for IHC staining using cytokeratin (CK) of AE1/AE3. IHC staining for p53, an apoptosis protein associated with poor prognosis in esophageal cancer, was also performed. Results. 331 Ts/Ls staging lymph node biopsies were collected from 106 patients. A total of 15.4% (51/331) of the lymph nodes or 34.9% (37/106) of patients were found to have metastatic deposits by routine histology. All the histologically positive lymph nodes were CK positive. Among the remaining 280 histologically negative lymph nodes, 11(3.9%) were found to have micrometastasis by CK staining. Three patients (4.3%, 3/69) were upstaged from N0 to N1. They died of early recurrences after treatment. A total of 67.6% (25/37) of the patients with histologically positive lymph node were p53 positive. No histologically negative lymph node was found to be p53 positive in this series. Conclusions. Immunohistochemical analysis for CK can detect micrometastatic involvement of lymph nodes that are missed on routine pathologic examination, and, therefore, can improve lymph node staging. Its clinical significance in esophageal cancer warrants further study.

AB - Background. With recent advances in neoadjuvant therapy in esophageal cancer, pretreatment lymph node staging has become increasingly important in stratifying patients to appropriate treatment regimens and for prognostication. Immunohistochemical analysis (IHC) using epithelial markers has been shown to identify micrometastases in histologically negative lymph nodes. We performed this study to evaluate if IHC analysis in thoracoscopic/laparoscopic (Ts/Ls) pretreatment staging lymph nodes can reveal additional diagnostic information to routine histopathology. Methods. Specimens of 106 patients with esophageal cancer who had pretreatment Ts/Ls staging were retrospectively studied. Lymph node biopsies were obtained for IHC staining using cytokeratin (CK) of AE1/AE3. IHC staining for p53, an apoptosis protein associated with poor prognosis in esophageal cancer, was also performed. Results. 331 Ts/Ls staging lymph node biopsies were collected from 106 patients. A total of 15.4% (51/331) of the lymph nodes or 34.9% (37/106) of patients were found to have metastatic deposits by routine histology. All the histologically positive lymph nodes were CK positive. Among the remaining 280 histologically negative lymph nodes, 11(3.9%) were found to have micrometastasis by CK staining. Three patients (4.3%, 3/69) were upstaged from N0 to N1. They died of early recurrences after treatment. A total of 67.6% (25/37) of the patients with histologically positive lymph node were p53 positive. No histologically negative lymph node was found to be p53 positive in this series. Conclusions. Immunohistochemical analysis for CK can detect micrometastatic involvement of lymph nodes that are missed on routine pathologic examination, and, therefore, can improve lymph node staging. Its clinical significance in esophageal cancer warrants further study.

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