Comparative detection of lymph node micrometastases of stage II XXXX by reverse transcriptase polymerase chain reaction and immunohistochemistry.

@entity1 @entity5 @entity787 @entity982 @entity14 @entity30
PURPOSE: Inconsistent conclusions have been drawn about the clinical significance of micrometastases in lymph nodes (LNs) of node-negative @entity14 ( @entity14 ) @entity1 . We performed a comparative study of detection of micrometastases using immunohistochemistry (IHC) by anti-cytokeratin antibody and @entity787 ( @entity787 )-specific reverse-transcriptase polymerase chain reaction (RT-PCR) in the same @entity1 , in an attempt to move closer to their clinical application. @entity1 AND METHODS: Sixty-four @entity14 @entity1 , with RNA of good quality available from @entity982 -embedded LN specimens, were selected from 84 stage II @entity1 who underwent curative surgery between 1988 and 1996. We investigated associations between the presence of micrometastases by each method and prognosis. RESULTS: Micrometastases were detected in 19 (29.6%) of 64 @entity1 by RT-PCR and in 35 (54.7%) of 64 @entity1 by IHC. By RT-PCR analysis, @entity1 exhibiting a positive band for @entity787 mRNA had a significantly worse prognosis than those who were RT-PCR-negative, with respect to both disease-free and overall survival (P =.027 and.015, respectively). By IHC analysis, the presence of micrometastasis did not predict @entity1 outcome in terms of either disease-free or overall survival. Infiltrating pattern of @entity5 growth characteristic was significantly associated with shorter disease-free survival among various clinical or pathologic factors. By multivariate Cox regression analysis, micrometastasis detected by RT-PCR and the @entity30 were both independent prognostic factors. CONCLUSION: Micrometastases detected by RT-PCR, but not IHC, may be of clinical value in identifying @entity1 who may be at high risk for recurrence of @entity14 and who are therefore likely to benefit from systemic adjuvant therapy.
