Comparing the efficacy of routine H&E staining and cytokeratin immunohistochemical staining in detection of micro-metastasis on serial sections of dye-mapped sentinel lymph nodes in colorectal carcinoma
نویسندگان
1 Department of Pathology-Acquired Immunodeficiency Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
2 Department of General Surgery, Isfahan University of Medical Sciences, Isfahan, Iran
3 Department of General Surgery, Isfahan University of Medical Sciences, Isfahan, Iran
4 Department of General Surgery, Isfahan University of Medical Sciences, Isfahan, Iran
5 Department of Pathology, School of Medicine, Arak University of Medical Sciences, Arak, Iran
6 Department of Pathology-Acquired Immunodeficiency Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
doi
چکیده
Background: The significance of techniques used for detecting micro-metastasis (MM) or isolated tumor cells (ITCs) is a controversial issue among investigators. We evaluated the different techniques used on sentinel lymph node (SLN) to detect MM/ITCs.Materials and Methods: Ninety-one SLNs of 15 patients underwent serial section with 100 ΅m interval. In each level, two sections were prepared. One section was stained with H&E and another with anti-cytokeratin antibody (immunohistochemistry). Then the sections were evaluated for detecting MM/ITCs. Results were analyzed by chi-square test.Results: 1656 sections of 91 SLNs of 15 patients were evaluated by a pathologist; MM was found in 1 and ITCs in 1 case. Overall, 2 out of 15 cases (13.3% of the patients) showed MM/ITCs by IHC staining. So, serial section along with using IHC was superior than serial section and routine H&E staining. But it did not affect the 5-year survival of the patients (P = 0.47).Conclusion: Using the combined techniques of serial section and IHC staining could up-stage 13.3% of colon cancer patients who were lymph node negative. In other studies with different combination of serial section, IHC staining, and PCR, investigators were able to find MM/ITCs in 3-39% of the cases. In our study, although serial section and IHC staining could up-stage 13.3% of patients, it could not affect the 5-year survival of the patients.
