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Jain V, Sakhuja P, Agarwal AK, Sirdeshmukh R, Siraj F, Gautam P. Lymph Node Metastasis in Gastrointestinal Carcinomas: A View from a Proteomics Perspective. Curr Oncol 2024; 31:4455-4475. [PMID: 39195316 DOI: 10.3390/curroncol31080333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 05/14/2024] [Accepted: 05/23/2024] [Indexed: 08/29/2024] Open
Abstract
Lymph node metastasis (LNM) is one of the major prognostic factors in human gastrointestinal carcinomas (GICs). The lymph node-positive patients have poorer survival than node-negative patients. LNM is directly associated with the recurrence and poor survival of patients with GICs. The early detection of LNM in patients and designing effective therapies to suppress LNM may significantly impact the survival of these patients. The rapid progress made in proteomic technologies could be successfully applied to identify molecular targets for cancers at high-throughput levels. LC-MS/MS analysis enables the identification of proteins involved in LN metastasis, which can be utilized for diagnostic and therapeutic applications. This review summarizes the studies on LN metastasis in GICs using proteomic approaches to date.
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Affiliation(s)
- Vaishali Jain
- Indian Council of Medical Research, National Institute of Pathology, New Delhi 110029, India
- Faculty of Health Sciences, Manipal Academy of Higher Education (MAHE), Manipal 576104, India
| | - Puja Sakhuja
- Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi 110002, India
| | - Anil Kumar Agarwal
- Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi 110002, India
| | - Ravi Sirdeshmukh
- Faculty of Health Sciences, Manipal Academy of Higher Education (MAHE), Manipal 576104, India
- Institute of Bioinformatics, International Tech Park, Bangalore 560066, India
| | - Fouzia Siraj
- Indian Council of Medical Research, National Institute of Pathology, New Delhi 110029, India
| | - Poonam Gautam
- Indian Council of Medical Research, National Institute of Pathology, New Delhi 110029, India
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Kawakami GDS, Pereira MA, Kubrusly MS, Carrasco AGM, Ramos MFKP, Ribeiro Júnior U. TUMOR MARKERS EXPRESSION LEVELS IN GASTRIC CANCER PATIENT'S PERIPHERAL BLOOD BY RT-PCR ASSESSMENT. ARQUIVOS BRASILEIROS DE CIRURGIA DIGESTIVA : ABCD = BRAZILIAN ARCHIVES OF DIGESTIVE SURGERY 2024; 36:e1789. [PMID: 38324850 PMCID: PMC10841496 DOI: 10.1590/0102-672020230071e1789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 10/10/2023] [Indexed: 02/09/2024]
Abstract
BACKGROUND Hematological recurrence is the second most frequent cause of failure in the treatment of gastric cancer. The detection of circulating tumor markers in peripheral blood by quantitative reverse transcriptase polymerase chain reaction (qRT-PCR) method may be a useful tool to predict recurrence and determine the patient's prognosis. However, no consensus has been reached regarding the association between the tumor markers level in peripheral blood and its impact on patient survival. AIMS To evaluate the expression of the circulating tumor markers CK20 and MUC1 in peripheral blood samples from patients with gastric cancer by qRT-PCR, and to verify the association of their expression levels with clinicopathological characteristics and survival. METHODS A total of 31 patients with gastric adenocarcinoma were prospectively included in this study. CK20 and MUC1 expression levels were analyzed from peripheral blood by the qRT-PCR technique. RESULTS There was no statistically significant (p>0.05) association between CK20 expression levels and clinical, pathological, and surgical features. Higher MUC1 expression levels were associated with female patients (p=0.01). There was a correlation between both gene levels (R=0.81, p<0.001), and CK20 level and tumor size (R=0.39, p=0.034). CONCLUSIONS CK20 and MUC1 expression levels could be assessed by qRT-PCR from total peripheral blood samples of patients with gastric cancer. CK20 levels were correlated to MUC1 levels as well as to tumor size. There was no difference in disease-free survival and overall survival regarding both genetic markers expression in this series.
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Affiliation(s)
- Gabriel da Silva Kawakami
- Universidade de São Paulo, Instituto do Câncer, Hospital das Clínicas, Faculty of Medicine, Department of Gastroenterology, São Paulo (SP), Brazil
| | - Marina Alessandra Pereira
- Universidade de São Paulo, Instituto do Câncer, Hospital das Clínicas, Faculty of Medicine, Department of Gastroenterology, São Paulo (SP), Brazil
| | - Márcia Saldanha Kubrusly
- Universidade de São Paulo, Instituto do Câncer, Hospital das Clínicas, Faculty of Medicine, Department of Gastroenterology, São Paulo (SP), Brazil
| | - Alexis Germán Murillo Carrasco
- Universidade de São Paulo, Instituto do Câncer, Hospital das Clínicas, Faculty of Medicine, Department of Gastroenterology, São Paulo (SP), Brazil
| | | | - Ulysses Ribeiro Júnior
- Universidade de São Paulo, Instituto do Câncer, Hospital das Clínicas, Faculty of Medicine, Department of Gastroenterology, São Paulo (SP), Brazil
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Impact of multisection and immunohistochemistry in lymph node staging of Gastric Carcinoma - Case series. Sci Rep 2020; 10:3271. [PMID: 32094351 PMCID: PMC7040007 DOI: 10.1038/s41598-020-59000-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 01/23/2020] [Indexed: 11/12/2022] Open
Abstract
Gastric carcinoma (GC) locoregional recurrence may occur even in cases where the tumor has been completely resected, possibly due to lymph node (LN) micrometastases. It is estimated that in 10% to 30% of cases, LN micrometastases are not detected by a conventional method for histological assessment of LN metastases with hematoxylin-eosin (HE). A cross-sectional study assessed 51 patients with GC by histological evaluation of the LN micrometastases through LN multi sectioning associated with immunohistochemistry analysis with monoclonal antibodies AE1 and AE3. Total gastrectomy was performed in 51% of patients. The total number of resected LN nodes was 1698, with a mean number of resected LN of 33.3 ± 13.2 per surgical specimen, of which 187 had metastasis. After the application of LN multisection and immunohistochemistry, LN micrometastases were found in 45.1% of the cases. LN staging changed in 29.4%, and tumor staging changed in 23.5% of the cases. In patients initially staged as pN0, LN staging and tumor staging changed, both in 19.2% of the cases. In patients initially staged as pN1 or more, LN staging changed in 40.0% of them, and tumor staging changed in 28.0% of the cases. The accuracy of HE for the histological staging of LN tumoral involvement was 76%, which was considered insufficient for CG patients staging. Investigation of LN micrometastasis through LN multisection and immunohistochemistry should be performed, particularly in cases where the presence of blood and lymphatic vessel invasion has been identified after conventional histological analysis, as well as in patients with advanced GC.
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Fiehn AMK, Jepsen DNM, Achiam MP, Ugleholdt H, Federspiel B. Isolated tumor cells in regional lymph nodes in patients with adenocarcinoma of the esophagogastric junction might represent part of true metastases. Hum Pathol 2019; 93:90-96. [DOI: 10.1016/j.humpath.2019.08.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 08/15/2019] [Accepted: 08/15/2019] [Indexed: 12/26/2022]
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Lütken CD, Fiehn AMK, Federspiel B, Achiam MP. Impact of isolated tumor cells in regional lymph nodes in adeno-and squamous cell carcinoma of the esophagus and the esophagogastric junction-A systematic review. Pathol Res Pract 2019; 215:849-854. [PMID: 30723054 DOI: 10.1016/j.prp.2019.01.040] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 01/09/2019] [Accepted: 01/29/2019] [Indexed: 01/19/2023]
Abstract
BACKGROUND/INTRODUCTION Isolated tumor cells (ITC) are tumor cells identified in the regional lymph nodes of patients with adeno- or squamous cell carcinoma of the esophagogastric junction (EGJ) or the esophagus. The current staging guidelines for these cancers do not assign any prognostic relevance to ITC, but their role remains debatable. We evaluated current literature to provide an overview of the prognostic relevance of ITC in regional lymph nodes of patients diagnosed with node negative cancer of the esophagus and EGJ. METHODS A systematic search of several databases according to PRISMA guidelines. Three main criteria for inclusion were selected: 1. The studies had to include a group of patients with histopathologically identified ITC as defined by the Union for International Cancer Control Tumor, Node, Metastasis-classification 8th edition. 2. The studies had to include a group of patients classified as pN0. 3. The studies had to present the survival rate of patients with pN0, ITC. RESULTS A total of five studies met the inclusion criteria. Combined, the studies included 434 pN0-patients of which 88 patients had ITC when evaluating the lymph nodes more extensively. The rate of ITC varied from 8% to 56% between studies. Significant differences in surgical techniques, neoadjuvant treatment and histological subtypes were observed. Three studies found a significant prognostic impact of ITC while one did not, and one had conflicting results. The largest difference in 5-year-survival was 33% for patients with ITC compared with 60% without ITC. CONCLUSION Although, the results were conflicting, ITC appeared to be a negative prognostic factor in esophageal and EGJ cancer. However, heterogeneity between the studies did not allow for a definitive conclusion.
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Affiliation(s)
- Christian D Lütken
- Department of Surgical Gastroenterology Rigshospitalet, Copenhagen University Hospital, Inge Lehmanns Vej 7, 2100, Copenhagen Ø, Denmark.
| | - Anne-Marie K Fiehn
- Department of Pathology, Rigshospitalet, Copenhagen University Hospital, Frederik V's Vej 11, 2100, Copenhagen Ø, Denmark
| | - Birgitte Federspiel
- Department of Pathology, Rigshospitalet, Copenhagen University Hospital, Frederik V's Vej 11, 2100, Copenhagen Ø, Denmark
| | - Michael P Achiam
- Department of Surgical Gastroenterology Rigshospitalet, Copenhagen University Hospital, Inge Lehmanns Vej 7, 2100, Copenhagen Ø, Denmark
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Evaluation the Survival of Patients with Gastric Cancer Treated with Adjuvant or Palliative Chemotherapy. J Gastrointest Cancer 2017; 48:31-37. [PMID: 27543101 DOI: 10.1007/s12029-016-9868-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
AIM Our aim was to evaluate impact of chemotherapy (5-fluorouracil plus docetaxel and cisplatin) on the survival of gastric cancer cases. METHOD Seventy-nine patients were eligible to take part in this study between November 2006 and April 2013, who received 5-fluorouracil (700 mg/m2, 21-h infusion within 5 days), cisplatin (60 mg/m2 on day 3), and Docetaxel (60 mg/m2 on day 2). Radiotherapy was added to the treatment only in the cases with entire stomach body cancer (positive margin) and with giant ulcer (above 50 mm) in proximal gastric cancer. RESULTS Twenty-four patients were female and 55 were male. The median age was 54. In this study, 54 % of the tumors were located in the proximal and 46 % in the distal of stomach. Seventy five percent of patients were at stage I-III (adjuvant chemotherapy), and 25 % at stage IV (palliative chemotherapy). Ninety-one percent of the patients at stages I-II, 68.3 % of the patients at stage III, and one out of 20 patients at stage IV were alive at the end of follow-up. Median disease-free survival for the patients at stages I-III was 63 months, and the overall survival for all patients was 50 months. CONCLUSION The results of our study indicate that the survival of the patients with stomach cancer increases with chemotherapy. Radiotherapy was used for our patients with gastric cancer in specific cases.
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Pereira MA, Ramos MFKP, Dias AR, Yagi OK, Faraj SF, Zilberstein B, Cecconello I, Mello ESD, Ribeiro U. DETECTION OF OCCULT LYMPH NODE TUMOR CELLS IN NODE-NEGATIVE GASTRIC CANCER PATIENTS. ARQUIVOS BRASILEIROS DE CIRURGIA DIGESTIVA : ABCD = BRAZILIAN ARCHIVES OF DIGESTIVE SURGERY 2017; 30:30-34. [PMID: 28489165 PMCID: PMC5424683 DOI: 10.1590/0102-6720201700010009] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Accepted: 12/13/2016] [Indexed: 02/08/2023]
Abstract
BACKGROUND The presence of lymph nodes metastasis is one of the most important prognostic indicators in gastric cancer. The micrometastases have been studied as prognostic factor in gastric cancer, which are related to decrease overall survival and increased risk of recurrence. However, their identification is limited by conventional methodology, since they can be overlooked after routine staining. AIM To investigate the presence of occult tumor cells using cytokeratin (CK) AE1/AE3 immunostaining in gastric cancer patients histologically lymph node negative (pN0) by H&E. METHODS Forty patients (T1-T4N0) submitted to a potentially curative gastrectomy with D2 lymphadenectomy were evaluated. The results for metastases, micrometastases and isolated tumor cells were also associated to clinicopathological characteristics and their impact on stage grouping. Tumor deposits within lymph nodes were defined according to the tumor-node-metastases guidelines (7th TNM). RESULTS A total of 1439 lymph nodes were obtained (~36 per patient). Tumor cells were detected by immunohistochemistry in 24 lymph nodes from 12 patients (30%). Neoplasic cells were detected as a single or cluster tumor cells. Tumor (p=0.002), venous (p=0.016), lymphatic (p=0.006) and perineural invasions (p=0.04), as well as peritumoral lymphocytic response (p=0.012) were correlated to CK-positive immunostaining tumor cells in originally negative lymph nodes by H&E. The histologic stage of two patients was upstaged from stage IB to stage IIA. Four of the 28 CK-negative patients (14.3%) and three among 12 CK-positive patients (25%) had disease recurrence (p=0.65). CONCLUSION The CK-immunostaining is an effective method for detecting occult tumor cells in lymph nodes and may be recommended to precisely determine tumor stage. It may be useful as supplement to H&E routine to provide better pathological staging.
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Affiliation(s)
- Marina Alessandra Pereira
- Hospital das Clínicas
- Cancer Institute, University of São Paulo Medical School, São Paulo, SP, Brazil
| | | | - Andre Roncon Dias
- Hospital das Clínicas
- Cancer Institute, University of São Paulo Medical School, São Paulo, SP, Brazil
| | - Osmar Kenji Yagi
- Hospital das Clínicas
- Cancer Institute, University of São Paulo Medical School, São Paulo, SP, Brazil
| | - Sheila Friedrich Faraj
- Hospital das Clínicas
- Cancer Institute, University of São Paulo Medical School, São Paulo, SP, Brazil
| | - Bruno Zilberstein
- Hospital das Clínicas
- Cancer Institute, University of São Paulo Medical School, São Paulo, SP, Brazil
| | - Ivan Cecconello
- Hospital das Clínicas
- Cancer Institute, University of São Paulo Medical School, São Paulo, SP, Brazil
| | - Evandro Sobroza de Mello
- Hospital das Clínicas
- Cancer Institute, University of São Paulo Medical School, São Paulo, SP, Brazil
| | - Ulysses Ribeiro
- Hospital das Clínicas
- Cancer Institute, University of São Paulo Medical School, São Paulo, SP, Brazil
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