Detection of pelvic lymph node micrometastasis in stage I_A～II_A cervical cancer by immunohistochemical assay

Objective To explore the clinical significance of immunohistochemical staining in detecting the pelvic lymph node micrometastasis in stage ⅠA~ⅡA cervical cancer.Methods We retrospectively reviewed the medical records of 27 patients,who underwent radical hysterectomy and lymphadenectomy for FIGO stage ⅠA~ⅡA cervical cancer at the First Affiliated Hospital of China Medical University from January to December,2006.A total of 490 lymph nodes were negative.Paraffin-embedded pelvic lymphadenectomy specimens were serially sectioned and stained with anti-cytokeratin antibodies AE1/AE3.Results Among 490 lymph nodes,micrometastasis was found in 5 lymph nodes of 5 patients.The positive rate of micrometastasis was 18.5%(5/27,95%CI 11%,43%)and the positive rate of lymph nodes was 1.02%(5/490).Among the lymph nodes with micrometastasis,the positive rate of external iliac lymph nodes and obturator lymph nodes was 2.8%(3/108)and 1.5%(2/132).Patients with more than 20 lymph nodes removed were more likely to demonstrate micrometastasis(P0.05).Conclusion There is micrometastasis in the pelvic lymph nodes around the cervical cancer,and the detection of micrometastasis by immunohistochemical staining in the negative lymph nodes of cervical cancer may be helpful for the treatment and prognostic evaluation.