Clinial Value Of Pelvic Lymph Node Micrometastasis In Early Stage Cervical Cancer By Using Immunohisto-chemical Method

ObjectiveBy immunohistochemistry cytokeratin CK (high-molecular),CK (low-molecular) markers of early detection of pelvic lymph node micrometastasis in cervical cancer cases, to explore the immunohistochemical staining (immunohistochenmistry, IHC) detection of non-conventional pathological examination of lymph node metastasis patients with early cervical lymph node micrometastasis in the feasibility and reliability of analysis of lymph node micrometastasis and clinicopathological factors related to the detection of micrometastasis to assess the clinical value.Methods1. Tissue collectionCollect the First Affiliated Hospital of China Medical University, from the January 2006 to June in 2008, 30 cases of newly diagnosed case in the early stage of cervical cancer were admitted, all patients did not undergo pre-operative radiotherapy and chemotherapy .meanwhile, all patients were operated for a broad range hysterectomy pelvic lymph node dissection in my hospital. Retrospect the 30 cases patient of clinical data, all patients aged 28-55 years (average 41.5 years old) six cases of cervical adenocarcinoma, twenty-four cases of squamous cell carcinoma. According to FIGO stages: LA period of seven cases, IB period of 20 cases, IIA period of three cases. We collected by conventional pathology confirmed negative lymph nodes 370, 76 lymph nodes of adenocarcinomas, 294 lymph nodes of squamous cell carcinoma.2. MethodsParaffin-embedded pelvic lymphadenectomy specimens were serially sectioned and stained with anti-cytokeratin Cytokeratin(high Polymer) Cytokeratin(low- molecular-weight). The working concentration of antibodies Cytokeratin(high Polymer) Cytokeratin(low -molecular-weight), was 1:100. All procedures were implemented according to the product illustration.3. Statistical AnalysisThe data were evaluated by chi-square test and Fisher's exact probabilities, SPSS13.0.Result1. The evidence of micrometastasis was found in 9(2.43%) of 370 lymph nodes from 5(16.67%) of 30 cases. Among the lymph nodes with micrometatasis, the positive rate of external iliac lymph nodes and obtutator lymph nodes was 3.19% and 5.68%. the positive rate of inguinal Lymph nodes was 1.61%. other lymph nodes has no micrometastasis.2. The Positive rate of obtutator lymph nodes was best.3. In some clinical features, we found the incidence of micrometastasis was related with clinical stage. The positive rate of micrometastasis increased.With the progression of clinical stage(P<0.05). In the other clinical features, such as tumor volume, depth of invasion, the incidence of micrometastasis was not significant differences.Conclusions1. There is micrometastasis in the pelvic lymph nodes around the cervical cancer of early stage, and the detection of micrometastasis by immunohistochemical staining in the negative lymph nodes. The positive rate of micrometastasis increased with the number of lymph nodes.2. The positive rate of obtutator lymph nodes was higer than other lymph nodes meanwhile, The micrometastasis increases with the progression of clinical stage.3. These results can be helpful for the tumor stages, treatment and prognosis evaluation.