Lymph node revealing solution: a new method for lymph node sampling: results in gastric adenocarcinoma

Area of Science:

• Surgical Oncology
• Gastrointestinal Pathology
• Diagnostic Imaging

Background:

• Accurate staging of gastric carcinoma is critical and relies heavily on lymph node assessment.
• Small lymph nodes are often obscured by perigastric adipose tissue, hindering detection with traditional methods.
• Inadequate lymph node retrieval can lead to inaccurate tumor staging (N-stage).

Purpose of the Study:

• To evaluate the efficacy of a novel lymph node revealing solution (LNRS) in improving lymph node detection during gastric cancer staging.
• To assess the impact of LNRS on the accuracy of lymph node (N) staging in gastric adenocarcinoma.

Main Methods:

• Perigastric adipose tissue from ten gastric carcinoma cases with fewer than 10 lymph nodes identified traditionally was immersed in LNRS for 6-12 hours.
• Lymph nodes were visualized as white nodules after LNRS treatment and then excised for routine processing.
• Comparison of lymph node yield and size between the traditional method and the LNRS-assisted method.

Main Results:

• The traditional method yielded 30 lymph nodes (mean size 6.69 ± 3.43 mm).
• LNRS revealed an additional 89 lymph nodes (mean size 3.03 ± 3.43 mm), significantly smaller than those found traditionally.
• Lymph node (N) stage was altered in six cases (Nx to N0 in four, N1 to N2 in one, N0 to N2 in one).

Conclusions:

• The lymph node revealing solution (LNRS) is a valuable technique for enhancing lymph node detection in gastric cancer staging.
• LNRS improves the accuracy of N-staging, particularly in cases where traditional methods yield fewer than 10 lymph nodes.
• This method is recommended for patients with gastric adenocarcinoma requiring precise staging when initial lymph node retrieval is suboptimal.