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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 2/2012

01-02-2012 | Gastrointestinal Oncology

Molecular Detection of Sentinel Node Micrometastases in Patients with Clinical N0 Gastric Carcinoma with Real-time Multiplex Reverse Transcription-Polymerase Chain Reaction Assay

Authors: Yoshimasa Shimizu, MD, Hiroya Takeuchi, MD, PhD, Yasuhiko Sakakura, PhD, Yoshiro Saikawa, MD, PhD, Tadaki Nakahara, MD, PhD, Makio Mukai, MD, PhD, Masaki Kitajima, MD, PhD, Yuko Kitagawa, MD, PhD

Published in: Annals of Surgical Oncology | Issue 2/2012

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Abstract

Purpose

Described is a novel real-time multiplex reverse transcription-polymerase chain reaction (RT-PCR) assay suitable for intraoperative detection of micrometastasis (MM) in sentinel nodes (SNs) dissected from patients with clinical N0 (cN0) gastric carcinoma.

Methods

One hundred three patients with gastric cancer, who were preoperatively diagnosed with cN0 and clinical T1 or T2, were enrolled. The patients underwent SN mapping followed by standard radical gastrectomy with lymph node dissection. In addition to all SNs, non-SNs (NSNs) within the SN lymphatic basin and NSN from a different lymphatic basin were randomly sampled. All SNs and NSNs were examined by routine histologic diagnosis and RT-PCR for the expression of cytokeratin (CK) 19, CK20, and carcinoembryonic antigen (CEA).

Results

The RT-PCR assay and histologic examination were performed in 512 SNs and 299 NSNs from 103 patients. Pathologic l lymph node metastasis was revealed in 13 (12.6%) of 103 patients. All metastatic lymph nodes were identified within SNs. SNs of these 13 patients had positive findings on RT-PCR. Twenty-eight (27.2%) of 103 patients had negative histopathology but positive findings on RT-PCR. In 7 patients (6.8%), SNs were negative but NSNs were positive on RT-PCR. RT-PCR-positive NSNs were present in the same station as corresponding SNs in 3 of these 7 patients and in the same basin as SNs in 4 patients.

Conclusions

The real-time multiplex RT-PCR assay is a useful tool for the detection of MM in SNs and NSNs in patients with gastric cancer.
Literature
1.
Wong JH, Cagle LA, Morton DL, et al. Lymphatic drainage of skin to a sentinel node in feline model. Ann Surg. 1991;214:637–41.PubMedCrossRef
2.
Morton DL, Wen DR, Wong JH, et al. Technical details of intraoperative lymphatic mapping for early stage melanoma. Arch Surg. 1992;127:392–9.PubMedCrossRef
3.
Veronesi U, Paganelli G, Galimberti V, et al. Sentinel-node biopsy to avoid axillary dissection in breast cancer with clinically negative lymph nodes. Lancet. 1997;349:1864–7.PubMedCrossRef
4.
Edwards MJ, Martin KD, McMasters KM, et al. Lymphatic mapping and sentinel lymph node biopsy in the staging of melanoma. Surg Oncol. 1998;7:51–7.PubMedCrossRef
5.
Holmes EC, Moseley HS, Morton DL, et al. A rational approach to the surgical management of melanoma. Ann Surg. 1977;186:481–90.PubMedCrossRef
6.
Lee SE, Lee JH, Ryu KW, et al. Sentinel node mapping and skip metastases in patients with early gastric Cancer. Ann Surg Oncol. 2009;16:603–8.PubMedCrossRef
7.
Kitagawa Y, Kitajima M. Sentinel node mapping for gastric cancer: is the jury still out? Gastric Cancer. 2004;7:135–7.PubMedCrossRef
8.
Kitagawa Y, Fujii H, Mukai M, et al. Radio-guided sentinel node detection for gastric cancer. Br J Surg. 2002;89:604–8.PubMedCrossRef
9.
Kitagawa Y, Kitajima M. Gastrointestinal cancer and sentinel node navigation surgery. J Surg Oncol. 2002;79:188–93.PubMedCrossRef
10.
Saha S, Dan AG, Bilchik AJ, et al. Historical review of lymphatic mapping in gastrointestinal malignancies. Ann Surg Oncol. 2004;11:245S–59S.PubMedCrossRef
11.
Takeuchi H, Kitajima M, Kitagawa Y, et al. Sentinel lymph node as a target of molecular diagnosis of lymphatic micrometastasis and local immunoresponse to malignant cells. Cancer Sci. 2008;99:441–50.PubMedCrossRef
12.
Arigami T, Natsugoe S, Uenosono Y, et al. Evaluation of sentinel node concept in gastric cancer based on lymph node micrometastasis determined by reverse transcription-polymerase chain reaction. Ann Surg. 2006;243:341–7.PubMedCrossRef
13.
Matsuda J, Kitagawa Y, Fujii H, et al. Significance of metastasis detected by molecular techniques in sentinel nodes of patients with gastrointestinal cancer. Ann Surg Oncol. 2004;11:250–4.
14.
Suo J, Wang Q, Jin HJ, et al. K-19 mRNA RT-PCR in detecting micrometastasis in regional lymph nodes of gastric cancer. World J Gastroenterol. 2006;12:5219–22.PubMed
15.
Bilchik AJ, Saha S, Wiese D, et al. Molecular staging of early colon cancer on the basis of sentinel node analysis: a multicenter phase II trial. J Clin Oncol. 2001;19:1128–36.PubMed
16.
Mori M, Minori K, Inoue H, et al. Detection of cancer micrometastases in lymph node by reverse transcriptase–polymerase chain reaction. Cancer Res. 1995;55:3412–20.
17.
Fujita Y, Terashima M, Hoshino Y, et al. Detection of cancer cells disseminated in bone marrow using real-time quantitative RT-PCR of CEA, CK19 and CK20 mRNA in patients with gastric cancer. Gastric Cancer. 2006;9:308–14.PubMedCrossRef
18.
Japanese Gastric Cancer Association. Japanese classification of gastric carcinoma. 14th ed. Tokyo: Kanehara; 2010.
19.
Kitagawa Y, Fujii H, Mukai M, et al. The role of sentinel nodes in gastrointestinal cancer. Surg Clin N Am. 2000;80:1799–809.PubMedCrossRef
20.
Kinami S, Fujimura T, Ojima E, et al. PTD classification: proposal for a new classification of gastric cancer location based on physiological lymphatic flow. Int J Clin Oncol. 2008;13:320–9.PubMedCrossRef
21.
Yanagita S, Natsugoe S, Uenosono Y, et al. Detection of micrometastases in sentinel node navigation surgery for gastric cancer. Surg Oncol. 2008;17:203–10.PubMedCrossRef
22.
Gerhard M, Juhl H, Holthoff H, et al. Specific detection of carcinoemboric antigen expressing tumor cells in bone marrow aspirates by polymerase chain reaction. J Clin Oncol. 1994;12:725–9.PubMed
23.
Moll R, Franke WW, Schiller DL, et al. The catalog of human cytokeratins: patterns of expression in normal epithelia, tumor and cultured cells. Cell. 1982;31:11–24.PubMedCrossRef
24.
Ruud P, Fodstad O, Hovig E, et al. Identification of a novel cytokeratin19 pseudogene that may interfere with reverse transcriptase–polymerase chain reaction assays used to detect micrometastatic tumor cells. Int J Cancer. 1999;80:119–25.PubMedCrossRef
25.
Hoon DS, Wang Y, Dale PS, et al. Detection of occult melanoma cells in blood with a multiple marker polymerase chain reaction assay. J Clin Oncol. 1995;13:2109–16.PubMed
26.
Okada Y, Fujiwara Y, Yamamoto H, et al. Genetic detection of lymph node micrometastases in patients with gastric carcinoma by multiple-marker reverse transcriptase–polymerase chain reaction assay. Cancer. 2001;92:2056–64.PubMedCrossRef
27.
Nakajo A, Natsugoe S, Ishigami S, et al. Detection and prediction of micrometastasis in the lymph nodes of patients with pN0 gastric cancer. Ann Surg Oncol. 2000;8:158–62.CrossRef
28.
Miyake K, Seshimo A, Kameoka S, et al. Assessment of lymph node micrometastasis in early gastric cancer in relation to sentinel nodes. Gastric Cancer. 2006;9:197–202.PubMedCrossRef
29.
Lee JH, Ryu KW, Kook MC, et al. Feasibility of laparoscopic sentinel basin dissection for limited resection in early gastric cancer. J Surg Oncol. 2008;98:331–5.PubMedCrossRef
30.
Kitagawa Y, Ohgami M, Fujii H, et al. Laparoscopic detection of sentinel lymph nodes in gastrointestinal cancer: a novel and minimally invasive approach. Ann Surg Oncol. 2001;8:86–9.
31.
Ohdaira H, Nimura H, Mitsumori N, et al. Validity of modified gastrectomy combined with sentinel node navigation surgery for early gastric cancer. Gastric Cancer. 2007;10:117–22.PubMedCrossRef
32.
Takeuchi H, Saikawa Y, Kitagawa Y, et al. Laparoscopic sentinel node navigation surgery for early gastric cancer. Asian J Endosc Surg. 2009;2:13–7.CrossRef
Metadata
Title
Molecular Detection of Sentinel Node Micrometastases in Patients with Clinical N0 Gastric Carcinoma with Real-time Multiplex Reverse Transcription-Polymerase Chain Reaction Assay
Authors
Yoshimasa Shimizu, MD
Hiroya Takeuchi, MD, PhD
Yasuhiko Sakakura, PhD
Yoshiro Saikawa, MD, PhD
Tadaki Nakahara, MD, PhD
Makio Mukai, MD, PhD
Masaki Kitajima, MD, PhD
Yuko Kitagawa, MD, PhD
Publication date
01-02-2012
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 2/2012
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-011-2122-4

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