Comparing the efficacy of routine H&E staining and cytokeratin immunohistochemical staining in detection of micro-metastasis on serial sections of dye-mapped sentinel lymph nodes in colorectal carcinoma

• Main Authors: Mohammad Hossein Sanei, Seid Abbas Tabatabie, Seid Mozafar Hashemi, Ali Cherei, Parvin Mahzouni, Behnam Sanei
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2016-01-01
• Series: Advanced Biomedical Research
• Subjects: Colorectal cancer; cytokeratin; immunohistochemistry; micro-metastasis; sentinel lymph node
• Online Access: http://www.advbiores.net/article.asp?issn=2277-9175;year=2016;volume=5;issue=1;spage=13;epage=13;aulast=Sanei

Background: The significance of techniques used for detecting micro-metastasis (MM) or isolated tumor cells (ITCs) is a controversial issue among investigators. We evaluated the different techniques used on sentinel lymph node (SLN) to detect MM/ITCs. Materials and Methods: Ninety-one SLNs of 15 patients underwent serial section with 100 ΅m interval. In each level, two sections were prepared. One section was stained with H&E and another with anti-cytokeratin antibody (immunohistochemistry). Then the sections were evaluated for detecting MM/ITCs. Results were analyzed by chi-square test. Results: 1656 sections of 91 SLNs of 15 patients were evaluated by a pathologist; MM was found in 1 and ITCs in 1 case. Overall, 2 out of 15 cases (13.3% of the patients) showed MM/ITCs by IHC staining. So, serial section along with using IHC was superior than serial section and routine H&E staining. But it did not affect the 5-year survival of the patients (P = 0.47). Conclusion: Using the combined techniques of serial section and IHC staining could up-stage 13.3% of colon cancer patients who were lymph node negative. In other studies with different combination of serial section, IHC staining, and PCR, investigators were able to find MM/ITCs in 3-39% of the cases. In our study, although serial section and IHC staining could up-stage 13.3% of patients, it could not affect the 5-year survival of the patients.