Annals of Surgical Oncology

, Volume 19, Issue 12, pp 3719–3726 | Cite as

Prognostic Relevance of Occult Metastases Detected by Cytokeratin 20 and Mucin 2 mRNA Levels in Sentinel Lymph Nodes from Colon Cancer Patients

  • Oddmund Nordgård
  • Satu Oltedal
  • Ole Gunnar Aasprong
  • Jon Arne Søreide
  • Kjetil Søreide
  • Kjersti Tjensvoll
  • Bjørnar Gilje
  • Reino Heikkilä
  • Marianne Guriby
  • Ragnhild A. Lothe
  • Rune Smaaland
  • Hartwig Kørner
Colorectal Cancer

Abstract

Purpose

To investigate the prognostic value of occult metastases detected by quantitative measurements of candidate biomarkers in sentinel lymph nodes (SLNs) from patients curatively resected for colon cancer.

Methods

Resection specimens from consecutive patients undergoing surgery for localized colon cancer were subjected to ex vivo SLN mapping. SLNs were examined for the presence of metastases by routine hematoxylin–erythrosin–safranin staining and by cytokeratin 20 (CK20) and mucin 2 (MUC2) mRNA quantification. The patients were stratified according to KRAS and BRAF mutation status and microsatellite instability status in their primary tumors. Survival end points were analyzed by Kaplan–Meier survival estimates and log-rank tests.

Results

A total of 817 SLNs were identified in 206 (97 %) of the 213 included patients. Routine histological examination of SLNs and other regional lymph nodes identified 63 patients with positive nodes (pN+), of which 42 (67 %) were positive in one or more SLNs (sensitivity 67 %, false-negative rate 33 %). On the basis of the CK20 and MUC2 mRNA levels in SLNs, occult metastases were suggested in 86 (60 %) and 52 (36 %) of the 143 otherwise LN-negative (pN0) patients, respectively. Survival analysis with a median 3.6-year follow-up revealed that MUC2 mRNA quantification had significant prognostic value in SLNs from all patients; however, occult SLN metastasis detection did not.

Conclusions

Occult SLN metastases detected by CK20 and MUC2 mRNA quantification had limited prognostic value.

Keywords

Sentinel Lymph Node Colon Cancer Patient Sentinel Lymph Node Mapping Sentinel Lymph Node Metastasis Occult Metastasis 

Notes

Acknowledgment

This work was supported by the Norwegian Cancer Society, the Western Norway Regional Health Authority, the Folke Hermansen Fund, and Stavanger University Hospital.

Conflict of interest

Reino Hekkilä is presently employed at Roche Norway, AS.

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Copyright information

© Society of Surgical Oncology 2012

Authors and Affiliations

  • Oddmund Nordgård
    • 1
  • Satu Oltedal
    • 1
  • Ole Gunnar Aasprong
    • 2
  • Jon Arne Søreide
    • 3
    • 4
  • Kjetil Søreide
    • 3
    • 4
  • Kjersti Tjensvoll
    • 1
  • Bjørnar Gilje
    • 1
  • Reino Heikkilä
    • 1
  • Marianne Guriby
    • 5
    • 6
  • Ragnhild A. Lothe
    • 5
    • 6
  • Rune Smaaland
    • 1
  • Hartwig Kørner
    • 3
    • 4
  1. 1.Department of Hematology and OncologyStavanger University HospitalStavangerNorway
  2. 2.Department of PathologyStavanger University HospitalStavangerNorway
  3. 3.Department of SurgeryStavanger University HospitalStavangerNorway
  4. 4.Department of Surgical SciencesUniversity of BergenBergenNorway
  5. 5.Department of Cancer Prevention, Institute for Cancer ResearchOslo University HospitalOsloNorway
  6. 6.Centre for Cancer Biomedicine, Faculty of MedicineUniversity of OsloOsloNorway

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