Extensive lymphatic spread of cancer cells in patients with thoracic esophageal squamous cell carcinoma: Detection of CEA-mRNA in the three-field lymph nodes

Yu Imamura, Naoko Hayashi, Nobutaka Sato, Koichi Kinoshita, Junji Kurashige, Seiya Saito, Kotaro Hirashima, Ryuichi Karashima, Yukiharu Hiyoshi, Yohei Nagai, Masayuki Watanabe, Hideo Baba

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10 Citations (Scopus)

Abstract

Background and Objectives: The aim of this study is to clarify the extent of lymphatic spread of cancer cells using a novel genetic test to examine patients with thoracic esophageal squamous cell carcinoma (ESCC). Methods: A total of 35 patients who underwent an esophagectomy with three-field lymph node (LN) dissection were eligible. The regional LN stations were categorized into the cervical (C), recurrent nerve (RN), paraesophageal (PE), tracheo-bronchial (TB), and perigastric (PG) nodes. Lymphatic spread was pathologically diagnosed with Hematoxylin-Eosin (HE) and anti-cytokeratin immunohistochemistry (IHC) staining, and CEA-mRNA expression was examined using the transcription-reverse transcription concerted (TRC) reaction. Results: The rates of lymphatic spread with HE, IHC, and TRC were 7.2%, 10.1%, and 55.5%, respectively. The number of CEA-mRNA(+) LN stations significantly correlated with tumor depth, LN metastasis diagnosed by HE, and vascular invasions. CEA-mRNA expression was observed in 42.9%, 94.3%, 77.1%, 80.0%, and 82.9% of C, RN, TB, PE, and PG nodes, respectively. Conclusions: The high frequency of CEA-mRNA expression suggests that systemic therapy is necessary in addition to esophagectomy with adequate LN dissection. Conversely, a relatively low frequency of CEA-mRNA expression in the C node does not support the routine dissection of the LNs in this area.

Original languageEnglish
Pages (from-to)509-515
Number of pages7
JournalJournal of Surgical Oncology
Volume102
Issue number5
DOIs
Publication statusPublished - Oct 1 2010

All Science Journal Classification (ASJC) codes

  • Surgery
  • Oncology

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    Imamura, Y., Hayashi, N., Sato, N., Kinoshita, K., Kurashige, J., Saito, S., Hirashima, K., Karashima, R., Hiyoshi, Y., Nagai, Y., Watanabe, M., & Baba, H. (2010). Extensive lymphatic spread of cancer cells in patients with thoracic esophageal squamous cell carcinoma: Detection of CEA-mRNA in the three-field lymph nodes. Journal of Surgical Oncology, 102(5), 509-515. https://doi.org/10.1002/jso.21621