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Significance of lymph node micrometastasis in pN0 hilar bile duct carcinoma
K Taniguchi1, M Tabata, T Iida
1First Department of Surgery, Mie University School of Medicine, 2-174, Edobashi, Tsu City, Mie Prefecture 514-8507, Japan. taniken@clin.medic.mie-u.ac.jp
Aims:
To examine micrometastasis in node-negative hilar bile duct carcinoma (HBDC) using an immunohistochemical method and evaluated the clinical significance.
Methods:
Four hundred and twenty three regional lymph nodes from 28 patients with node-negative HBDC who had undergone a resection were immunostained with an antibody against cytokeratins eight and 18 (CAM 5.2).
Results:
Lymph node micrometastasis was detected in 11 of the 28 patients and 14 of the 423 lymph nodes. Lymph node micrometastasis was significantly correlated with the pT classification (p=0.03), the histopathological grading (p=0.01) and venous invasion (p=0.05). The 5-year survival rate of the patients with lymph node micrometastasis was 21.8%, as opposed to 66.5% in the patients without micrometastasis. Patients with micrometastasis showed a significantly poorer survival rate than those without micrometastasis (p=0.02).
Conclusion:
The results suggest that immunohistochemically detected lymph node micrometastasis has an impact on the outcome in HBDC.
