Küçük Hücre Dışı Akciğer Kanserli, Mediyastinoskopik Lenf Nodu Biyopsileri Tümör Negatif Hastalarda Sitokeratinle Mikrometastaz Araştırılması

Abstract

ABSTRACT Introduction-Objectives Although curative resections are routinely performed in early stage non-small cell lung cancers (NSCLC), disease recurence is still frequent in about one-third of the patients and disease outcome is poorer than expected. Thus it has been suggested that there may be micrometastases which are undetectable by routine techniques during the surgery. Recent advances in molecular biology provide novel methods that may detect the micrometastases. In this study, we investigated the micrometastases to seen in NSCLC by using an epithelial marker cytokeratin. Material and Methods: Twenty patiens who had been diagnosed as NSCLC in Ondokuz Mayıs Universty School of Medicine, Thoracic Surgery Clinic between 2003 and 2004 were enrolled in this study. All patients had mediastinal ipsilateral lymph nodes (RN2) and their mediastinoscopic lymph node biopsies were PN0. Micrometastases were investigated by using immunohistochemical cytokeratin staging Results: All patient were male. Median age was 60.9 (51-74). Sixteen squamous cell carcinoma, two Adenocarcinoma and two bronchoalveolar carcinoma were detected in histopathological examination. Cervical mediastinoscopy was performed in all patients who had RN2 in thorax CT and complete resection was done in PNo patients. Sixty lymph nodes, 40 were taken by mediastinoscopy and rest of then surgically, were examined by immunohistochemical staining. Only one lymph node from a single patient were found to be micrometastatic IXConclusion Jmmunohistochemical methods seen to helpful in detecting micrometastases in NSCLCs. Standard cervical mediastnoscopy in still important in preoperative staging since it is 1 00% specific and 90 % sensitive. Key words: Lung cancer, mediastinoscopy.cytokeratin. X