Document Detail


Sentinel lymph node mapping and molecular staging in nonsmall cell lung carcinoma.
MedLine Citation:
PMID:  16130135     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Lymph node (LN) involvement predicts recurrence in patients who have undergone resection of apparently localized nonsmall cell lung carcinoma (NSCLC). Standard detection methods for LN disease have a low sensitivity, and many patients with apparent N0 disease status develop recurrent disease. Molecular techniques can improve the detection of micrometastases, whereas sentinel lymph node (SLN) mapping can indicate which LN may contain micrometastases. These methods, although potentially complementary, have not, to the authors' knowledge, been used together previously. METHODS: The authors used SLN mapping and molecular staging to improve the detection of LN micrometastases in patients with NSCLC. Reverse transcriptase-polymerase chain reaction (RT-PCR) analysis for cytokeratin-7 (CK7), expressed both in normal lung and in malignant lung, was used to identify tumor-derived material in LN. RESULTS: SLN mapping was performed in 13 patients, with 1-3 SLNs identified in each patient, and sufficient RNA for RT-PCR was obtained in 12 of these 13 patients. Eleven of 12 tumors expressed CK7. Overall, 32 LNs were positive for CK7, including 13 of 21 SLNs. Ten of 11 patients with evaluable SLNs had at least 1 CK7-positive SLN. Routine pathology showed Stage I disease in eight patients, T3N0 disease in one patient, and LN-positive disease in two patients. Of the nine patients with N0 disease according to routine pathology that was evaluable by RT-PCR, eight patients were upstaged by this technique. All patients with positive LN status by routine pathology who were evaluable by RT-PCR analysis had positive RT-PCR results. CONCLUSIONS: LN micrometastases were common in resected NSCLC, including patients with N0 disease according to routine pathology. SLN mapping was useful for identifying disease-containing LNs. This approach may be useful for stratifying histologically N0 patients into higher risk and lower risk groups.
Authors:
Dianne Pulte; Eric Li; Bernard K Crawford; Elliot Newman; Alice Alexander; David C Mustalish; Daniel R Jacobson
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Cancer     Volume:  104     ISSN:  0008-543X     ISO Abbreviation:  Cancer     Publication Date:  2005 Oct 
Date Detail:
Created Date:  2005-09-23     Completed Date:  2005-12-01     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0374236     Medline TA:  Cancer     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1453-61     Citation Subset:  AIM; IM    
Affiliation:
Hematology/Oncology Research Service, Veterans Administration New York Harbor Healthcare System, New York, New York, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Base Sequence
Carcinoma, Non-Small-Cell Lung / mortality,  pathology*,  surgery
Cohort Studies
DNA, Neoplasm / analysis*
Humans
Lung Neoplasms / mortality,  pathology*,  surgery
Male
Middle Aged
Molecular Biology
Molecular Sequence Data
Neoplasm Invasiveness / pathology*
Neoplasm Staging / methods*
Pneumonectomy / methods
Predictive Value of Tests
Prognosis
Prospective Studies
Reverse Transcriptase Polymerase Chain Reaction / methods
Risk Assessment
Sensitivity and Specificity
Sentinel Lymph Node Biopsy*
Survival Analysis
Grant Support
ID/Acronym/Agency:
2T32 CA09454/CA/NCI NIH HHS
Chemical
Reg. No./Substance:
0/DNA, Neoplasm

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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