The study on detection of micrometastasis in lymph nodes and its prognostic significance in patients with PN_0 esophageal carcinoma

Objective To study the immunohistochemically diagnostic method of lymph node micrometastasis in patients with PN0 esophageal carcinoma and to evaluate its prognostic significance. Methods One hundred eighteen lymph nodes from 56 patients, diagnosed with N0 lymph node metastasis with routine hematoxylin and eosin (HE)staining,we reexamined immunohistochemically for the micrometastases of lymph nodes using cytokeratin 19 and mucin1 (muc1) monoclonal antibody. Results Lymph node micrometastases were observed in 14 of the 56 patients. There was no significant correlation between lymph node micrometastasis and clinical data,such as sex, age, size, location, pathologic type, but TNM stage(T1/T2,T3). The 3-year survival rate was 53.85% in patients with micrometastases of lymph nodes and 83. 63% in patients without micrometastases, it showed the significant difference(x2=7. 24,P0. 05) between them. The univariate analysis and multivariate analysis indicated that T stage tumor and micrometastases were independent progrostic factors. Conclusion Immunohistochemical staining using cytokeratin 19 and mucinl monoclonal antibody is more sensitive than routine histological method for detecting micrometastasis in lymph nodes. The clinical stage based on the micrometastasis is more accurate than that based on routine pathological method. Nodal micrometastasis can be immunohistochemically diagnosed by the detection of CK-19 and MUC1 in lymph nodes of patients with pN0 e-sophageal carcinoma. Lymph node micrometastases may play an important role in the prognosis of esophageal carcinoma.