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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 12/2012

01-11-2012 | Colorectal Cancer

Prognostic Relevance of Occult Metastases Detected by Cytokeratin 20 and Mucin 2 mRNA Levels in Sentinel Lymph Nodes from Colon Cancer Patients

Authors: Oddmund Nordgård, PhD, Satu Oltedal, Msc, Ole Gunnar Aasprong, MD, Jon Arne Søreide, MD, PhD, Kjetil Søreide, MD, PhD, Kjersti Tjensvoll, PhD, Bjørnar Gilje, MD, Reino Heikkilä, MD, PhD, Marianne Guriby, Msc, Ragnhild A. Lothe, PhD, Rune Smaaland, MD, PhD, Hartwig Kørner, MD

Published in: Annals of Surgical Oncology | Issue 12/2012

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Abstract

Purpose

To investigate the prognostic value of occult metastases detected by quantitative measurements of candidate biomarkers in sentinel lymph nodes (SLNs) from patients curatively resected for colon cancer.

Methods

Resection specimens from consecutive patients undergoing surgery for localized colon cancer were subjected to ex vivo SLN mapping. SLNs were examined for the presence of metastases by routine hematoxylin–erythrosin–safranin staining and by cytokeratin 20 (CK20) and mucin 2 (MUC2) mRNA quantification. The patients were stratified according to KRAS and BRAF mutation status and microsatellite instability status in their primary tumors. Survival end points were analyzed by Kaplan–Meier survival estimates and log-rank tests.

Results

A total of 817 SLNs were identified in 206 (97 %) of the 213 included patients. Routine histological examination of SLNs and other regional lymph nodes identified 63 patients with positive nodes (pN+), of which 42 (67 %) were positive in one or more SLNs (sensitivity 67 %, false-negative rate 33 %). On the basis of the CK20 and MUC2 mRNA levels in SLNs, occult metastases were suggested in 86 (60 %) and 52 (36 %) of the 143 otherwise LN-negative (pN0) patients, respectively. Survival analysis with a median 3.6-year follow-up revealed that MUC2 mRNA quantification had significant prognostic value in SLNs from all patients; however, occult SLN metastasis detection did not.

Conclusions

Occult SLN metastases detected by CK20 and MUC2 mRNA quantification had limited prognostic value.
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Metadata
Title
Prognostic Relevance of Occult Metastases Detected by Cytokeratin 20 and Mucin 2 mRNA Levels in Sentinel Lymph Nodes from Colon Cancer Patients
Authors
Oddmund Nordgård, PhD
Satu Oltedal, Msc
Ole Gunnar Aasprong, MD
Jon Arne Søreide, MD, PhD
Kjetil Søreide, MD, PhD
Kjersti Tjensvoll, PhD
Bjørnar Gilje, MD
Reino Heikkilä, MD, PhD
Marianne Guriby, Msc
Ragnhild A. Lothe, PhD
Rune Smaaland, MD, PhD
Hartwig Kørner, MD
Publication date
01-11-2012
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 12/2012
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-012-2454-8

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