The Impact of Immunohistochemical Detection of Positive Lymph Nodes in Early Stage Lung Cancer

C. Tezel; A. A. Ersev; H. Kıral; S. Urek; A. Kosar; M. Keles; C. Dudu; B. Arman

doi:10.1055/s-2005-872867

The Thoracic and Cardiovascular Surgeon, Table of Contents

Thorac Cardiovasc Surg 2006; 54(2): 124-128
DOI: 10.1055/s-2005-872867

Original Thoracic

The Impact of Immunohistochemical Detection of Positive Lymph Nodes in Early Stage Lung Cancer

C. Tezel¹ , A. A. Ersev² , H. Kıral¹ , S. Urek¹ , A. Kosar¹ , M. Keles¹ , C. Dudu¹ , B. Arman¹

¹Department of Thoracic Surgery, Heybeliada Chest Disease and Thoracic Surgery Center, Istanbul, Turkey
²Department of Pathology, Heybeliada Chest Disease and Thoracic Surgery Center, Istanbul, Turkey

Presented at the 41st Annual Meeting of the Society of Thoracic Surgeons, Tampa, FL, USA, January 24 - 26, 2005

Abstract

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Abstract

Background: Detection of micrometastatic disease is an interesting area in non-small cell lung cancer (NSCLC). We conducted a study to determine whether the detection of mediastinal lymph node spread by immunohistochemical (IHC) analysis offers some prognosis with respect to patients' disease-free survival or not. Methods: Between 1997 and 2003, twenty-one early stage lung cancer patients underwent complete resection with mediastinoscopy and systemic nodal dissection. Four hundred and twenty-six paraffin-embedded lymph node sections from 21 patients were analyzed. Epithelial specific-antigen Ab-9 and Keratin-Pan Ab-1 were used as IHC marker. Results: Based on nodal spread four of the 21 patients (19.04 %) were up-staged after IHC analysis. Two patients with stage IB (T2N0) up-staged to stage IIIA (T2N2); two patients staged as IIB (T2N1) up-staged to IIIA (T2N2). Statistical analysis showed that the lymphatic dissemination detected with IHC analysis was associated with reduced disease-free survival (DFS) (p = 0.002). Conclusions: Our study provides some indication that patients with lymphatic micrometastasis have a reduced DFS. Before creating a new TNM staging system, more information is needed to understand the prognostic impact of micrometastatic dissemination.

Key words

Lung cancer - diagnosis and staging - lymph nodes - immunohistochemistry

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M.D. Tezel Cagatay

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