Journal
EUROPEAN JOURNAL OF CANCER
Volume 41, Issue 2, Pages 306-312Publisher
ELSEVIER SCI LTD
DOI: 10.1016/j.ejca.2004.09.021
Keywords
cytokeratin; reverse transcriptase polymerase chain reaction; metastasis; lung neoplasm; thoracic surgery; lymph node dissection; mediastinum; prognosis
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This study was designed to screen occult cancer cells by CK19 mRNA detection using reverse transcriptase-polymerase chain reaction (RT-PCR) in mediastinal lymph nodes stations (MLNS) in non-small cell lung carcinoma (NSCLC). In 49 NSCLC patients free of mediastinal adenopathy on computed tomograph, 254 MLNS were evaluated by histopathology, immunohistochemistry (IHC) and RT-PCR. Of 225 non-tumoral MLNS on histopathology, 32 (14.2%) were positive by RT-PCR. IHC did not provide significant additional results. Seventeen patients were without mediastinal tumoral extension on histopathology and RT-PCR (Group 1), 16 were upgraded by RT-PCR (Group 2) and 16 pN2 on histopathology (Group 3). The two-year cancer-related death survival in Groups 1 (100%) and 2 (64.5%) was significantly different (P = 0.04). The relative risk of recurrence in Group 2 compared with Group 1, evaluated by the Cox model multivariate analysis, was 5.61 (P = 0.02). In conclusion, CK19 mRNA detected by RTPCR in MLNS was significantly associated with an increased risk of rapid recurrence. (C) 2004 Elsevier Ltd. All rights reserved.
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