The detection of cytokeratins in lymph nodes of Duke's B colorectal cancer subjects predicts a poor outcome

• Published in: European journal of gastroenterology & hepatology Vol. 12; no. 5; p. 549
• Main Authors: Clarke, G, Ryan, E, O'Keane, J C, Crowe, J, MacMathuna, P
• Format: Journal Article
• Language: English
• Published: England 01-05-2000
• Subjects: Biomarkers, Tumor - analysis; Colorectal Neoplasms - pathology; Female; Humans; Immunohistochemistry; Keratins - analysis; Lymph Nodes - pathology; Lymphatic Metastasis - pathology; Male; Prognosis; Proportional Hazards Models; Survival Analysis
• ISSN: 0954-691X
• DOI: 10.1097/00042737-200012050-00012

The objectives of this study were to examine the frequency of lymph node micrometastases detected by keratin immunohistochemistry and their relationship with survival behaviour.
A total of 133 consecutive patients staged as Duke's B, who had curative resection for colorectal cancer (CRC), comprised the study population. Patients who had died of a non-CRC-related cause or who became lost to follow-up were excluded, resulting in an amended population of 100. Study end-points were defined as disease-free survival of 5 years or CRC-related death. Paraffin-embedded lymph node sections were stained with a commercial cytokeratin antibody using a standard avidin-biotin technique.
One quarter of subjects had micrometastases. Fifty-six per cent of subjects with positive lymph nodes had an adverse outcome, compared with 11% of subjects with negative nodes. A highly significant association was found between lymph node cytokeratin expression and mortality in both the univariate (log rank P = 0.0001) and multivariate (Cox proportional hazards P = 0.0123) analysis.
Lymph node micrometastases detected by this inexpensive and simple technique are significantly associated with mortality in Duke's B CRC. This technique may be used to select patients for adjuvant chemotherapy.