DETECTION OF OCCULT TUMOR CELLS IN RESECTED LYMPH NODES OF PATIENTS WITH STAGE I CARCINOMA AND ITS CLINICOPATHOLOGICAL SIGNIFICANCE

Objective: A lot of 3715 resected lymph nodes from 350 stage I cancer patients, including 94 NSCLC, 112 breast carcinoma, 115 esophageal carcinoma, and 29 vulvar carcinoma cases, were re examined by immuno histochemistry. Methods: Using monoclonal anti cytokeratins (AE1/AE3), anti EMA, and polyclonal anti keratin antibodies, the tumor cell micrometastases were detected to obtain more reliable information concerning the nodal status. Results: Nodal occult metastases were observed in 113 of 350 (32.5%) patients and in 203 of 3715 (5.5%) nodes. The positive rates in both patients and nodes were higher in NSCLC than in others (P<0.05). The nodal occult metastases were seen in 58% of pulmonary squamous cell carcinoma and 53.8% of adenocarcinoma, while they were seen in 22.5% of esophageal and 10.3% of vulvar squamous cell carcinomas and in 27.7% of breast adenocarcinoma (P<0.05). Follow up of a part of breast carcinoma patients showed that the clinical prognosis was worse in patients with positive nodes than in negative ones (P< 0.05 ). Conclusion: The data suggested that the immunohistochemical techniques can significantly facilitate the detection of micrometastatic tumor cells in lymph nodes. The frequency of nodal occult metastases may have important impact on the clinical prognosis of cancer patients.

Occult cervical lymph node metastases in 100 consecutive patients with cNO tongue cancer

Background Squamous cell carcinoma （SCC） of the tongue maxillofacial region. To provide clinical evidence for selective analyzing the characteristics and correlation of factors of occult with SCC of the tongue. is one of the most common cancers in the oral and neck dissection in management of cN0 patients by cervical lymph node metastases （OCLNM） in patients Methods From 2002 to 2006, 100 consecutive patients with SCC of the tongue were reviewed by analyzing the characteristics of OCLNM, diameter of the tumor, T classifications, depth of invasion, forms of growth, pathological grade and degree of differentiation. Results The rate of OCLNM in 100 patients with SCC of the tongue was 22%. The most common region with OCLNM was level Ⅱ in the ipsilateral neck, followed by levels Ⅰ and Ⅲ. There were 51.61% （16/31） of OCLNM in level Ⅱ and 87.10% （27/31） of OCLNM in levels Ⅰ-Ⅲ. There was no significant correlation between the diameter of tumor and OCLNM （P 〉0.05）. OCLNM was statistically significantly correlated with the depth of invasion, forms of growth, pathological grade and degree of differentiation （P 〈0.05）. The rate of occult metastases increased with the increased pathological grade, the decreased degree of differentiation and the increased depth of invasion. Conclusions The most common regions with OCLNM in cN0 patients with SCC of the tongue were levels Ⅰ-Ⅲ in the ipsilateral neck. Supraomohyoid neck dissection should be the elective treatment to the neck in patients with cN0 SCC of the tongue by consideration of the clinical and pathological factors for the depth of invasion, forms of growth, pathological grade, and degree of differentiation.