Identify Micrometastasis in Lymph Nodes of Gastric Cancer Use qRT-PCR Assay and Evaluate The Clinical Significance of Micrometastasis_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 LUuml , Chengyu , XIE Honghu , WANG Bei , CHEN Wei , YUAN Aihua

Department of General Surgery， Nanjing Medical University Affiliated Nanjing First Hospital， Nanjing 210006， Jiangsu Province， China;

Corresponding author：

LUuml, Email: lcy_1234@yahoo.com.cn

Keywords：

Gasric cancer; Lymph nodes; Micrometastasis; Quantitative real-time reverse transcription-PCR

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Objective 　To identify micrometastasis in regional lymph nodes of gastric cancer by quantitative real-time reverse transcription-PCR (qRT-PCR) assay and to evaluate the clinical significance of micrometastasis.
Methods 　To study 320 lymph nodes collected from January 2010 to June 2010， 281 of which were from 40 patients with gastric cancer who had undergone a standard gastrectomy with lymphadenectomy， and other 39 of which were from 10 patients with gastroduodenal ulcer. Made CEA， CK-19， and CK-20 as primers， and used qRT-PCR assay in addition to hematoxylin and eosin staining to detect the micrometastasis， and to analyze the clinicopathologic characteristics.
Results 　Totally， micrometastasis were detected by qRT-PCR assay in 31 (15.34%，31/202) lymph nodes of 28 (70.00%， 28/40) patients. Thirty-nine lymph nodes from 10 patients with gastroduodenal ulcer were negative by qRT-PCR and HE staining. The degree of differentiation， depth of gastric mural invasion， and clinical stage had statistically significant correlation with the incidence of lymph node micrometastasis (P＜0.05).
Conclusions 　qRT-PCR assay is a sensitive and speciﬁc method to detect lymph node micrometastasis in gastric cancer patients，and it has importantly clinical significance in evaluating clinical staging，prognosis and treatment prescription.

Citation： LUuml,Chengyu,XIE Honghu,WANG Bei,CHEN Wei,YUAN Aihua,YIN Xindao.. Identify Micrometastasis in Lymph Nodes of Gastric Cancer Use qRT-PCR Assay and Evaluate The Clinical Significance of Micrometastasis. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2012, 19(1): 31-36. doi: Copy

1.	Kodera E， Fujiwara M， Ito Y， et al. Radical surgery for gastric carcinoma：it is not an issue of whether to perform D1 or D2.Dissect as many lymph nodes as possible and you will be rewarded [J]. Acta Chir Belg， 2009， 109(1)： 27-35.
2.	Coburn NG. Lymph nodes and gastric cancer [ J]. J Surg Oncol，2009， 99(4)： 199-206.
3.	Yanagita S， Natsugoe S， Uenosono Y， et al. Detection of micrometastases in sentinel node navigation surgery for gastric cancer [J]. Surg Oncol， 2008， 17(3)： 203-210.
4.	Aurello P， D’angelo F， Nigri G， et al. Comparison between site N-category and number N-category for nodal staging in carcinoma of the gastroesophageal junction： our experience and literature review [J]. Am Surg， 2006， 72(2)： 118-123.
5.	Cai J， Ikeguchi M， Maeta M， et al. Micrometastasis in lymph nodes and microinvasion of the muscularis propria in primary lesions of submucosal gastric cancer [J]. urgery， 2000， 127(1)：32-39.
6.	Kim DY， Joo JK， Ryu SY， et al. Factors related to lymph node metastasis and surgical strategy used to treat early gastric carcinoma[J]. World J Gastroenterol， 2004， 10(5)： 737-740.
7.	Folli S， Morgagni P， Roviello F， et al. Risk factors for lymph node metastases and their prognostic significance in early gastric cancer (EGC) for the Italian Research Group for Gastric Cancer (IRGGC) [J]. Jpn J Clin Oncol， 2001， 31(10)： 495-499.
8.	何清，焦洁茹，魏旭倩，等. 胃癌患者外周血癌胚抗原、细胞角蛋白20 及生存素基因检测的临床意义 [J]. 诊断学理论与实践， 2010， 9(1)： 74-78．.
9.	Fujita Y， Terashima M， Hoshino Y， et al. Detection of cancer cells disseminated in bone marrow using real-time quantitative RT-PCR of CEA， CK19， and CK20 mRNA in patients with gastric cancer [J]. Gastric Cancer， 2006， 9(4)： 308-314.
10.	Livak KJ， Schmittgen TD. Analysis of relative gene expression data using real-time quantitative PCR and the 2〔-Delta Delta C (T)〕Method [J]. Methods， 2001， 25(4)： 402-408.
11.	Huvos AG， Hutter RV， Berg JW. Significance of axillary macrometastases and micrometastases in mammary cancer [J]. Ann Surg， 1971， 173(1)： 44-46.
12.	Nasser IA， Lee AK， Bosari S， et al. Occult axillary lymph node metastases in“ node-negative” breast carcinoma [J]. Hum Pathol， 1993， 24(9)： 950-957.
13.	Kubota K， Nakanishi H， Hiki N， et al. Quantitative detection of micrometastases in the lymph nodes of gastric cancer patients with real-time RT-PCR： a comparative study with immunohistochemistry [J]. Int J Cancer， 2003， 105(1)： 136-143.
14.	Miyake Y， Fujiwara Y， Ohue M， et al. Quantification of micrometastases in lymph nodes of colorectal cancer using real-time fluorescence polymerase chain reaction [J]. Int J Oncol， 2000，16(2)： 289-293.
15.	Nakanishi H， Kodera Y， Yamamura Y， et al. Rapid quantitative detection of carcinoembryonic antigen-expressing free tumor cells in the peritoneal cavity of gastric-cancer atients with real-time RT-PCR on the lightcycler [J]. Int J Cancer， 2000， 89(5)： 411-417.
16.	Kodera Y， Nakanishi H， Ito S， et al. Quantitative detection of disseminated free cancer cells in peritoneal washes with realtime reverse transcriptase-polymerase chain reaction： a sensitive predictor of outcome for patients with gastric carcinoma [J]. Ann Surg， 2002， 235(4)： 499-506.
17.	Arigami T， Natsugoe S， Uenosono Y， et al. Evaluation of sentinel node concept in gastric cancer based on lymph node micrometastasis determined by reverse transcription-polymerase chain reaction [J]. Ann Surg， 2006， 243(3)： 341-347.
18.	Matsumoto M， Natsugoe S， Ishigami S， et al. Lymph node micrometastasis and lymphatic mapping determined by reverse transcriptase-polymerase chain reaction in pN0 gastric carcinoma [J]. Surgery， 2002， 131(6)： 630-635.
19.	Okada Y， Fujiwara Y， Yamamoto H， et al. Genetic detection of lymph node micrometastases in patients with gastric carcinoma by multiple-marker reverse transcriptase-polymerase chain reaction assay [J]. Cancer， 2001， 92(8)： 2056-2064.
20.	Osaka H， Yashiro M， Sawada T， et al. Is a lymph node detected by the dye-guided method a true sentinel node in gastric cancer? [J]. Clin Cancer Res， 2004， 10(20)： 6912-6918.
21.	Higashi H， Natsugoe S， Ishigami S， et al. Distribution of lymph node metastasis including micrometastasis in gastric cancer with submucosal invasion [J]. World J Surg， 2003， 27(4)： 455-459.
22.	Arigami T， Natsugoe S， Uenosono Y， et al. Lymphatic invasion using D2-40 monoclonal antibody and its relationship to lymph node micrometastasis in pN0 gastric cancer [J]. Br J Cancer，2005， 93(6)： 688-693.
23.	Tajima Y， Murakami M， Yamazaki K， et al. Risk factors for lymph node metastasis from gastric cancers with submucosal invasion [J]. Ann Surg Oncol， 2010， 17(6)： 1597-1604.
24.	Miyake K， Seshimo A， Kameoka S. Assessment of lymph node micrometastasis in early gastric cancer in relation to sentinel nodes [J]. Gastric Cancer， 2006， 9(3)： 197-202.
25.	Kim JJ， Song KY， Hur H， et al. Lymph node micrometastasis in node negative early gastric cancer [J]. Eur J Surg Oncol， 2009， 35(4)： 409-414.
26.	Morgagni P， Saragoni L， Scarpi E， et al. Lymph node micrometastases in early gastric cancer and their impact on prognosis [J].World J Surg， 2003， 27(5)： 558-561.
27.	Harrison LE， Choe JK， Goldstein M， et al. Prognostic significance of immunohistochemical micrometastases in node negative gastric cancer patients [J] . J Surg Oncol， 2000， 73(3)： 153-157.
28.	Lee E， Chae Y， Kim I， et al. Prognostic relevance of immunohisto chemically detected lymph node micrometastasis in patients with gastric carcinoma [J]. Cancer， 2002， 94(11)： 2867-2873.中国普外基础与临床杂志2012 年1 月第19 卷第1 期 Chin J Bases ? 36 ? Clin General Surg, Vol. 19, No. 1, Jan. 2012.
29.	Yonemura Y， Endo Y， Hayashi I， et al. Proliferative activity of micrometastases in the lymph nodes of patients with gastric cancer [J]. Br J Surg， 2007， 94(6)： 731-736.
30.	Yanagita S， Natsugoe S， Uenosono Y， et al. Sentinel node micrometastases have high proliferative potential in gastric cancer [J]. J Surg Res， 2008， 145(2)： 238-243.
31.	Choi HJ， Kim YK， Kim YH， et al. Occurrence and prognostic implications of micrometastases in lymph nodes from patients with submucosal gastric carcinoma [J]. Ann Surg Oncol， 2002， 9(1)：13-19.
32.	Baba H， Maehara Y， Takeuchi H， et al. Effect of lymph node dissection on the prognosis in patients with node-negative early gastric cancer [J]. Surgery， 1995， 117(2)： 165-169.

1. Kodera E， Fujiwara M， Ito Y， et al. Radical surgery for gastric carcinoma：it is not an issue of whether to perform D1 or D2.Dissect as many lymph nodes as possible and you will be rewarded [J]. Acta Chir Belg， 2009， 109(1)： 27-35.
2. Coburn NG. Lymph nodes and gastric cancer [ J]. J Surg Oncol，2009， 99(4)： 199-206.
3. Yanagita S， Natsugoe S， Uenosono Y， et al. Detection of micrometastases in sentinel node navigation surgery for gastric cancer [J]. Surg Oncol， 2008， 17(3)： 203-210.
4. Aurello P， D’angelo F， Nigri G， et al. Comparison between site N-category and number N-category for nodal staging in carcinoma of the gastroesophageal junction： our experience and literature review [J]. Am Surg， 2006， 72(2)： 118-123.
5. Cai J， Ikeguchi M， Maeta M， et al. Micrometastasis in lymph nodes and microinvasion of the muscularis propria in primary lesions of submucosal gastric cancer [J]. urgery， 2000， 127(1)：32-39.
6. Kim DY， Joo JK， Ryu SY， et al. Factors related to lymph node metastasis and surgical strategy used to treat early gastric carcinoma[J]. World J Gastroenterol， 2004， 10(5)： 737-740.
7. Folli S， Morgagni P， Roviello F， et al. Risk factors for lymph node metastases and their prognostic significance in early gastric cancer (EGC) for the Italian Research Group for Gastric Cancer (IRGGC) [J]. Jpn J Clin Oncol， 2001， 31(10)： 495-499.
8. 何清，焦洁茹，魏旭倩，等. 胃癌患者外周血癌胚抗原、细胞角蛋白20 及生存素基因检测的临床意义 [J]. 诊断学理论与实践， 2010， 9(1)： 74-78．.
9. Fujita Y， Terashima M， Hoshino Y， et al. Detection of cancer cells disseminated in bone marrow using real-time quantitative RT-PCR of CEA， CK19， and CK20 mRNA in patients with gastric cancer [J]. Gastric Cancer， 2006， 9(4)： 308-314.
10. Livak KJ， Schmittgen TD. Analysis of relative gene expression data using real-time quantitative PCR and the 2〔-Delta Delta C (T)〕Method [J]. Methods， 2001， 25(4)： 402-408.
11. Huvos AG， Hutter RV， Berg JW. Significance of axillary macrometastases and micrometastases in mammary cancer [J]. Ann Surg， 1971， 173(1)： 44-46.
12. Nasser IA， Lee AK， Bosari S， et al. Occult axillary lymph node metastases in“ node-negative” breast carcinoma [J]. Hum Pathol， 1993， 24(9)： 950-957.
13. Kubota K， Nakanishi H， Hiki N， et al. Quantitative detection of micrometastases in the lymph nodes of gastric cancer patients with real-time RT-PCR： a comparative study with immunohistochemistry [J]. Int J Cancer， 2003， 105(1)： 136-143.
14. Miyake Y， Fujiwara Y， Ohue M， et al. Quantification of micrometastases in lymph nodes of colorectal cancer using real-time fluorescence polymerase chain reaction [J]. Int J Oncol， 2000，16(2)： 289-293.
15. Nakanishi H， Kodera Y， Yamamura Y， et al. Rapid quantitative detection of carcinoembryonic antigen-expressing free tumor cells in the peritoneal cavity of gastric-cancer atients with real-time RT-PCR on the lightcycler [J]. Int J Cancer， 2000， 89(5)： 411-417.
16. Kodera Y， Nakanishi H， Ito S， et al. Quantitative detection of disseminated free cancer cells in peritoneal washes with realtime reverse transcriptase-polymerase chain reaction： a sensitive predictor of outcome for patients with gastric carcinoma [J]. Ann Surg， 2002， 235(4)： 499-506.
17. Arigami T， Natsugoe S， Uenosono Y， et al. Evaluation of sentinel node concept in gastric cancer based on lymph node micrometastasis determined by reverse transcription-polymerase chain reaction [J]. Ann Surg， 2006， 243(3)： 341-347.
18. Matsumoto M， Natsugoe S， Ishigami S， et al. Lymph node micrometastasis and lymphatic mapping determined by reverse transcriptase-polymerase chain reaction in pN0 gastric carcinoma [J]. Surgery， 2002， 131(6)： 630-635.
19. Okada Y， Fujiwara Y， Yamamoto H， et al. Genetic detection of lymph node micrometastases in patients with gastric carcinoma by multiple-marker reverse transcriptase-polymerase chain reaction assay [J]. Cancer， 2001， 92(8)： 2056-2064.
20. Osaka H， Yashiro M， Sawada T， et al. Is a lymph node detected by the dye-guided method a true sentinel node in gastric cancer? [J]. Clin Cancer Res， 2004， 10(20)： 6912-6918.
21. Higashi H， Natsugoe S， Ishigami S， et al. Distribution of lymph node metastasis including micrometastasis in gastric cancer with submucosal invasion [J]. World J Surg， 2003， 27(4)： 455-459.
22. Arigami T， Natsugoe S， Uenosono Y， et al. Lymphatic invasion using D2-40 monoclonal antibody and its relationship to lymph node micrometastasis in pN0 gastric cancer [J]. Br J Cancer，2005， 93(6)： 688-693.
23. Tajima Y， Murakami M， Yamazaki K， et al. Risk factors for lymph node metastasis from gastric cancers with submucosal invasion [J]. Ann Surg Oncol， 2010， 17(6)： 1597-1604.
24. Miyake K， Seshimo A， Kameoka S. Assessment of lymph node micrometastasis in early gastric cancer in relation to sentinel nodes [J]. Gastric Cancer， 2006， 9(3)： 197-202.
25. Kim JJ， Song KY， Hur H， et al. Lymph node micrometastasis in node negative early gastric cancer [J]. Eur J Surg Oncol， 2009， 35(4)： 409-414.
26. Morgagni P， Saragoni L， Scarpi E， et al. Lymph node micrometastases in early gastric cancer and their impact on prognosis [J].World J Surg， 2003， 27(5)： 558-561.
27. Harrison LE， Choe JK， Goldstein M， et al. Prognostic significance of immunohistochemical micrometastases in node negative gastric cancer patients [J] . J Surg Oncol， 2000， 73(3)： 153-157.
28. Lee E， Chae Y， Kim I， et al. Prognostic relevance of immunohisto chemically detected lymph node micrometastasis in patients with gastric carcinoma [J]. Cancer， 2002， 94(11)： 2867-2873.中国普外基础与临床杂志2012 年1 月第19 卷第1 期 Chin J Bases ? 36 ? Clin General Surg, Vol. 19, No. 1, Jan. 2012.
29. Yonemura Y， Endo Y， Hayashi I， et al. Proliferative activity of micrometastases in the lymph nodes of patients with gastric cancer [J]. Br J Surg， 2007， 94(6)： 731-736.
30. Yanagita S， Natsugoe S， Uenosono Y， et al. Sentinel node micrometastases have high proliferative potential in gastric cancer [J]. J Surg Res， 2008， 145(2)： 238-243.
31. Choi HJ， Kim YK， Kim YH， et al. Occurrence and prognostic implications of micrometastases in lymph nodes from patients with submucosal gastric carcinoma [J]. Ann Surg Oncol， 2002， 9(1)：13-19.
32. Baba H， Maehara Y， Takeuchi H， et al. Effect of lymph node dissection on the prognosis in patients with node-negative early gastric cancer [J]. Surgery， 1995， 117(2)： 165-169.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Identify Micrometastasis in Lymph Nodes of Gastric Cancer Use qRT-PCR Assay and Evaluate The Clinical Significance of Micrometastasis

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