2004 Fiscal Year Final Research Report Summary
Immunohistochemical Evaluation of Nodal Micrometastases in Patients with Carcinoma of the Head of the Pancreas
| Project/Area Number |
14571184
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Digestive surgery
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| Research Institution | Kanazawa University |
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Principal Investigator |
KAYAHARA Masato Kanazawa University, Graduate School of Medical Science, Assistant Professor, 医学系研究科, 講師 (60224705)
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| Co-Investigator(Kenkyū-buntansha) |
OHTA Tetsuo Kanazawa University, Graduate School of Medical Science, Associate Professor, 医学系研究科, 助教授 (40194170)
KITAGAWA Hirohisa Kanazawa University, University Hospital, Lecturer, 医学部付属病院, 助手 (80272970)
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| Project Period (FY) |
2002 – 2004
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| Keywords | pancreas cancer / lymph node / micrometastasis / cytokeratin |
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| Research Abstract |
Background. Lymph node (LN) status is major determinant of disease recurrence after patients with curative resection for carcinoma of the head of the pancreas. Recent studies in a range of solid tumors have found a high incidence of micrometastases in the regional LNs, in spite of the absence of macroscopic lymph node involvement. In patients with carcinoma of the head of the pancreas, the significance of micrometastases of LNs remains controversial. The clinicopathologic significance of micrometastases in regional LNs without apparent involvements has not been evaluated by using immunohistochemical (IHC) staining for patients with carcinoma of the head of the pancreas.
Materials and Methods. Twenty-two patients with carcinoma of the head of the pancreas who underwent curative surgery at the Department of Surgery and Clinical Oncology, Kanazawa University between 1982 and 2001 were diagnosed as no nodal metastases by routine histological examination. Complete serial sections of 4-μm-thi
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ck section in 4μM thickness of the LNs were used for searching micrometastases of tumor cells in the lymph nodes. Over 30,000 consecutive slices were stained with H&E or IHC staining.
Results. Micrometastases were identified in 6 of 9 patients (66.7%) and in 10 of 474 lymph nodes (2.1%), respectively. Four micrometastases in the lymph nodes were found in Group 13a, two in Group 17a, two in Group 14a, one in Group 14b, and one in Group 14v lymph nodes, respectively. No micrometastasis in the paraaortic LNs was detected. No significant difference was found in overall survival between patients with micrometastases and those without micrometastases (p=0.58).
Conclusions. Although the presence of micrometastases in the regional LNs did not affect the survival of patients with carcinoma of the head of the pancreas, complete serial sectioning study was supposed to be one of the new clinicopathologic approaches for accurate evaluation of both the grading of lymphatic spread and pathological staging of the diseases. Therefore, extended lymph node dissection (including Group 12, 13, 14, and 17 lymph nodes) are necessary for patients with carcinoma of the head of the pancreas regarding resection of lymphatic basis. Less
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