• Title/Summary/Keyword: Lymph

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Factors Influencing Axillary Lymph Node Metastasis in Invasive Breast Cancer

  • Li, Ling;Chen, Li-Zhang
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.1
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    • pp.251-254
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    • 2012
  • Purpose: To explore the relationship between auxiliary lymph node metastasis and clinical features, and to identify the factors that affect metastasis occurrence. Methods: A total of 164 cases of primary breast cancer were selected to investigate features such as age, concomitant chronic disease and pathologic diagnosis. Immunohistochemistry was used to detect the expression of the estrogen receptor (ER) and CerbB-2. Logistic regression was employed to analyze the factors that affect the incidence of lymph node metastases. Results: The incidence of lymph node metastases was 46.3% among elderly patients with breast cancer. Based on logistic regression, chronic disease, scale of tumor, age, and ER expression affected the occurrence of lymph node metastases; the ORs were 3.05, 2.18, 0.34, and 3.83, respectively. Between different pathologic diagnoses and the risk factors, the OR scores were 12.7 and 8.02, respectively, for aggressive ductal carcinoma and aggressive lobular carcinoma auxiliary lymph node metastases. Conclusion: The incidence of lymph node metastases is affected by chronic disease, scale of tumor, age, ER expression and pathologic diagnosis.

Perigastric Lymph Node Metastasis from Papillary Thyroid Carcinoma in a Patient with Early Gastric Cancer: The First Case Report

  • Jeong, Gui-Ae;Kim, Hyung-Chul;Kim, Hee-Kyung;Cho, Gyu-Seok
    • Journal of Gastric Cancer
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    • v.14 no.3
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    • pp.215-219
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    • 2014
  • Distant metastasis from papillary thyroid carcinoma (PTC), particularly from papillary thyroid microcarcinoma, is rare. We present a case of perigastric lymph node metastasis from PTC in a patient with early gastric cancer and breast cancer. During post-surgical follow-up for breast cancer, a 56-year-old woman was diagnosed incidentally with early gastric cancer and synchronous left thyroid cancer. Therefore, laparoscopic distal gastrectomy with lymph node dissection and left thyroidectomy were performed. On the basis of the pathologic findings of the surgical specimens, the patient was diagnosed to have papillary thyroid microcarcinoma with perigastric lymph node metastasis and early gastric cancer with mucosal invasion. Finally, on the basis of immunohistochemical staining with galectin-3, the diagnosis of perigastric lymph node metastasis from PTC was made. When a patient has multiple primary malignancies with lymph node metastasis, careful pathologic examination of the surgical specimen is necessary; immunohistochemical staining may be helpful in determining the primary origin of lymph node metastasis.

Evaluation of Skin Sensitization Potential of Skin Whitening Agents by Local Lymph Node Assay (국소 림프절 시험법(Local lymph node assay)을 이용한 피부미백화장품 원료의 피부감작성 연구)

  • 이종권;박승희;박재현;김형수;엄준호;남기택;한범석;장동덕;최광식
    • Toxicological Research
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    • v.19 no.4
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    • pp.285-291
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    • 2003
  • The use of skin whitening agents has been recently increased in various kinds of cosmetic products, although there were some reports that whitening agents might cause allergic contact dermatitis. A murine local lymph node assay (LLNA) has been developed as an alternative to guinea pigs for contact sensitization potential. This study was carried out to investigate the skin sensitization potential of three whitening agents, arbutin, azelaic acid, and kojic acid, by LLNA using a non-radiois-topic endpoint. Female Balb/c mice were exposed topically to a weak allergen, $\alpha$-hexylcinnamalde-hyde (HCA), and three whitening agents following LLNA protocol. Lymph node (LN) weight and cell proliferation in ears and auricular lymph node using bromodeoxyuridine (BrdU) immunohistochemistry were evaluated. LN weights were significantly increased at the HCA group compared to the vehicle control. A weak allergen, HCA elicited 3-fold or greater increase in cell proliferation of lymph nodes as well as increase in cell proliferation of ear as measured by BrdU immunohistochemistry. However, in the case of skin whitening agent groups, there were no significant changes in LN weight and cell proliferation in the ear and lymph node of mice treated with 5, 10 and 20% of three whitening agents compared to the vehicle control. These results show that these three skin whitening agents may not have contact sensitization potentials at tested concentrations in Balb/c mice by LLNA.

Lactosaminated N-Succinyl-chitosan: Preparation and Biodistribution into the Intestine, Bone, Lymph Nodes and Male Genital Organs after I.v. Administration

  • Kato, Yoshinori;Onishi, Hiraku;Machida, Yoshiharu
    • Macromolecular Research
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    • v.11 no.5
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    • pp.382-386
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    • 2003
  • Reductive amination of N-succinyl-chitosan (1) and lactose using sodium cyanoborohydride in 1/15 M phosphate buffer (pH 6.0) for 6 d was suitable for the preparation of lactosaminated N-succinyl-chitosan (2). At 8, 24 and 48 h after i.v. administration of fluorescently labeled 1 (1') or 2 (2'), Peyer's patch, mesenteric lymph nodes, testes, prostate, preputial grand, intestine (small intestine plus cecum), femoral muscle, backbone and peritoneum were taken. Peyer's patch and mesenteric lymph nodes were put together as lymph nodes. Over 10% of dose/g tissue was distributed to the prostate and lymph nodes at 48 h post-administration in both l' and 2'.2' was easily distributed into not only the liver but also prostate, intestine, preputial gland and lymph nodes. Although galactose receptors are known to exist not only on the liver parenchymal cells but also on prostate and testes, the selective distribution of 2' into the prostate and the testes were not observed clearly. This study suggested that 1 and 2 should have possibilities for both the prevention and cure of lymph node metastasis as drug carriers.

What Should Thoracic Surgeons Consider during Surgery for Ground-Glass Nodules?: Lymph Node Dissection

  • Kim, Hong Kwan
    • Journal of Chest Surgery
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    • v.54 no.5
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    • pp.342-347
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    • 2021
  • Thoracic surgeons need to be aware of several important points regarding intraoperative lymph node dissection during surgery for non-small cell lung cancer with ground-glass opacities. The first point relates to the need for lymph node dissection during sublobar resection. Since even patients undergoing sublobar resection may benefit from lymph node dissection, it should be selectively performed according to adequate indications, which require further study. Second, there seems to be no difference in postoperative morbidity between systematic sampling and systematic dissection, but the survival benefit from systematic dissection remains unclear. The results of randomized controlled trials on this topic are conflicting, and their evidence is jeopardized by a high risk of bias in terms of the study design. Therefore, further randomized controlled trials with a sound design should investigate this issue. Third, more favorable survival outcomes tend to be positively associated with the number of examined lymph nodes. Minimum requirements for the number of examined lymph nodes in non-small cell lung cancer should be defined in the future. Finally, lobe-specific lymph node dissection does not have a negative prognostic impact. It should not be routinely performed, but it can be recommended in selected patients with smaller, less invasive tumors. Results from an ongoing randomized controlled trial on this topic should be awaited.

Epithelial-Specific SHP1-P2 Methylation - a Novel Universal Tumor Marker for Detection of Colorectal Cancer Lymph Node Metastasis

  • Rattanatanyong, Prakasit;Keelawat, Somboon;Kitkumthorn, Nakarin;Mutirangura, Apiwat
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.8
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    • pp.4117-4123
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    • 2016
  • Background: Methylation of promoter 2 of the SHP1 gene is epithelial cell specific, with reported potential as a lymph node metastatic marker. Objective: To demonstrate SHP1-P2 methylation-specific quantitative PCR effectiveness in detecting colorectal cancer (CRC) DNA in lymph nodes. Materials and Methods: SHP1-P2 methylation levels were measured in lymph nodes of CRC patients and compared with pathological findings and patient prognosis. Results: Lymph nodes of CRC metastatic patients without microscopically detectable cancer cells had higher SHP1-P2 methylation levels than lymph nodes of controls (p<0.001). In addition, a higher SHP1-P2 methylation level was associated with a shorter duration until adverse disease events, metastasis, recurrence and death (r2 = 0.236 and p value = 0.048). Studying two cohorts of 74 CRC patients without microscopic lymph node metastases showed that only the cohort containing samples with high SHP1-P2 methylation levels had a significant hazard ratio of 3.8 (95%CI = 1.02 to 14.2). Conclusions: SHP1-P2 methylation PCR can detect CRC DNA in lymph nodes even if cancer cells are not visible under a microscope, confirming applicability as a potential universal lymph node metastatic marker.

Evaluation of the 7th AJCC TNM Staging System in Point of Lymph Node Classification

  • Kim, Sung-Hoo;Ha, Tae-Kyung;Kwon, Sung-Joon
    • Journal of Gastric Cancer
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    • v.11 no.2
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    • pp.94-100
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    • 2011
  • Purpose: The 7th AJCC tumor node metastasis (TNM) staging system modified the classification of the lymph node metastasis widely compared to the 6th edition. To evaluate the prognostic predictability of the new TNM staging system, we analyzed the survival rate of the gastric cancer patients assessed by the 7th staging system. Materials and Methods: Among 2,083 patients who underwent resection for gastric cancer at the department of surgery, Hanyang Medical Center from July 1992 to December 2009, This study retrospectively reviewed 5-year survival rate (5YSR) of 624 patients (TanyN3M0: 464 patients, TanyNanyM1: 160 patients) focusing on the number of metastatic lymph node and distant metastasis. We evaluated the applicability of the new staging system. Results: There were no significant differences in 5YSR between stage IIIC with more than 29 metastatic lymph nodes and stage IV (P=0.053). No significant differences were observed between stage IIIB with more than 28 metastatic lymph nodes and stage IV (P=0.093). Distinct survival differences were present between patients who were categorized as TanyN3M0 with 7 to 32 metastatic lymph nodes and stage IV. But patients with more than 33 metastatic lymph nodes did not show any significant differences compared to stage IV (P=0.055). Among patients with TanyN3M0, statistical significances were seen between patients with 7 to 30 metastatic lymph nodes and those with more than 31 metastatic lymph nodes. Conclusions: In the new staging system, modifications of N classification is mandatory to improve prognostic prediction. Further study involving a greater number of cases is required to demonstrate the most appropriate cutoffs for N classification.

Is Her-2 Status in the Primary Tumor Correlated with Matched Lymph Node Metastases in Patients with Gastric Cancer Undergoing Curative Gastrectomy?

  • Selcukbiricik, Fatih;Erdamar, Sibel;Buyukunal, Evin;Serrdengecti, Suheyla;Demirelli, Fuat
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.24
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    • pp.10607-10611
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    • 2015
  • Background: HER2 expression in the primary tumor and its lymph node metastases vary in gastric cancer, reflecting intratumoral heterogeneity. This finding also suggests that proliferation of a different clone in metastatic nodes is possible. In the current study, we aimed to determine the cause of discordance in HER-2 expression in the primary tumor and lymph node metastases for patients with gastric cancer. Materials and Methods: Eighty-one patients with gastric cancer who had undergone radical gastrectomy and were found to have lymph node metastasis upon pathological examination were included. Histopathological samples were obtained from biopsies obtained during patient gastrectomies and lymph node dissection. HER2 status was evaluated by both immunohistochemistry (IHC) and silver in situ hybridization (SISH). Results: Sixty-four (79%) patients were SISH (-), while 17 (21%) were SISH (+) in the primary tumor. However, in metastatic lymph nodes, HER2 status was SISH positive in 5 (28.3%) of the 64 SISH (-) primary tumor specimens. One of the 17 SISH (+) primary tumors was SISH (-) in the metastatic lymph nodes. Thus, SISH results for HER2 in both primary tumors and lymph node metastases were comparable, showing a concordance of 92.5%. In total, six patients demonstrated discordance between the primary tumor and lymph node metastases. The prevalence of HER2 discordance was significantly higher for patients in the pN2 and N3 stages (p=0.007). Although discordant patients had worse survival rates than concordant patients, the differences were not significant (p>0.05).Conclusions: Our study indicates that the frequency of concordance in HER2 status, as determined by IHC or SISH, is high in primary tumors and their corresponding lymph node metastases for patients with gastric cancer. If there is a discrepancy in HER2 status, its evaluation by both IHC and SISH may be useful for detecting patients who would benefit from trastuzumab, and it would therefore help guide decision-making processes in administering treatment.

THE CLINICAL SIGNIFICANCE OF THE EXPRESSION OF TGF-${\beta}1$ AND MMP-2 RELATED TO THE REGIONAL LYMPH NODE METASTASIS IN THE ORAL SQUAMOUS CELL CARCINOMA (구강 편평 상피 암종에서 TGF-${\beta}1$과 MMP-2의 발현과 경부 임파절 전이 간의 상관 관계에 관한 연구)

  • Kim, Jwa-Young;Rotaru, Horatiu;Kim, Seong-Gon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.33 no.3
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    • pp.199-203
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    • 2007
  • Several matrix metalloproteinases (MMPs) have been shown to play an important role in the invasion and metastasis of oral squamous cell carcinoma (OSCC). The members of the TGF-$\beta$ signaling pathway are being considered as predictive biomarkers for progressive tumorigenesis and molecular targets for the prevention and the treatment of cancer and metastasis. The aim of the present study was to find the clinical significance of the expression of TGF-${\beta}1$ and MMP-2 related to the regional lymph node metastasis in OSCC. This study included 76 cases of primary OSCC, of which 42 cases showed regional lymph node metastases. Immunohistochemistry was used for the localization of protein. The relation between the expression of each protein and clinical variables was statistically evaluated. In results, the expression of TGF-${\beta}1$ both main mass with lymph node metastasis and without lymph node metastasis was found not to be statistically significant (p>0.05). The expression of MMP-2 was found to be statistically significant related to regional lymph node metastasis (p<0.05). When compared the expression in the metastatic lymph node, TGF-${\beta}1$ was significantly highly expressed than MMP-2 (p<0.05). In conclusion, the expression of MMP-2 was significantly elevated in patients with lymph node metastasis as compared to the patients without lymph node metastasis, which could be useful in predicting the risk of lymph node metastasis in OSCC.

Artificial Neural Network System in Evaluating Cervical Lymph Node Metastasis of Squamous Cell Carcinoma (편평세포암종 임파절 전이에 대한 인공 신경망 시스템의 진단능 평가)

  • Park Sang-Wook;Heo Min-Suk;Lee Sam-Sun;Choi Soon-Chul;Park Tae-Won;You Dong-Soo
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.29 no.1
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    • pp.149-159
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    • 1999
  • Purpose: The purpose of this study was to evaluate cervical lymph node metastasis of oral squamous cell carcinoma patients by MRI film and neural network system. Materials and Methods: The oral squamous cell carcinoma patients(21 patients. 59 lymph nodes) who have visited SNU hospital and been taken by MRI. were included in this study. Neck dissection operations were done and all of the cervical lymph nodes were confirmed with biopsy. In MR images. each lymph node were evaluated by using 6 MR imaging criteria(size. roundness. heterogeneity. rim enhancement. central necrosis, grouping) respectively. Positive predictive value. negative predictive value. and accuracy of each MR imaging criteria were calculated. At neural network system. the layers of neural network system consisted of 10 input layer units. 10 hidden layer units and 1 output layer unit. 6 MR imaging criteria previously described and 4 MR imaging criteria (site I-node level II and submandibular area. site II-other node level. shape I-oval. shape II-bean) were included for input layer units. The training files were made of 39 lymph nodes(24 metastatic lymph nodes. 10 non-metastatic lymph nodes) and the testing files were made of other 20 lymph nodes(10 metastatic lymph nodes. 10 non-metastatic lymph nodes). The neural network system was trained with training files and the output level (metastatic index) of testing files were acquired. Diagnosis was decided according to 4 different standard metastatic index-68. 78. 88. 98 respectively and positive predictive values. negative predictive values and accuracy of each standard metastatic index were calculated. Results: In the diagnosis of using single MR imaging criteria. the rim enhancement criteria had highest positive predictive value (0.95) and the size criteria had highest negative predictive value (0.77). In the diagnosis of using single MR imaging criteria. the highest accurate criteria was heterogeneity (accuracy: 0.81) and the lowest one was central necrosis (accuracy: 0.59). In the diagnosis of using neural network systems. the highest accurate standard metastatic index was 78. and that time. the accuracy was 0.90. Neural network system was more accurate than any other single MR imaging criteria in evaluating cervical lymph node metastasis. Conclusion: Neural network system has been shown to be more useful than any other single MR imaging criteria. In future. Neural network system will be powerful aiding tool in evaluating cervical node metastasis.

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