Immunochemical assays may help predict survival after lung cancer resection

NEW YORK (Reuters Health) – Using two immunohistochemical staining methods, occult lymph nodal metastases can be detected in patients with completely resected stage 1 nonsmall cell lung cancer (NSCLC), according to a recent report. The presence of disease can be helpful in predicting tumor recurrence and patient survival.

The 5-year survival rate for patients with completely resected NSCLC is 70%, suggesting that, in some patients, nodal micrometastases are present that are missed on routine analysis.

Dr. Toshihiro Osaki, from the University of Occupational and Environmental Health in Kitakyushu, Japan, and colleagues used cytokeratin and p53 immunohistochemistry staining techniques to determine the presence of occult nodal disease in 49 patients with completely resected stage 1 NSCLC. A total of 474 lymph nodes were analyzed.

Thirty-five nodes were positive for cytokeratin, the investigators note in the January issue of the Annals of Surgery. Of the 263 nodes from a p53-positive primary tumor, 20 were also positive for p53.

By combining both staining methods, the authors identified 22 patients who had occult lymph node metastases. These patients had a significantly poorer prognosis than those without micrometastases.

"The detection of lymph node occult micrometastatic tumor cells by using cytokeratin and p53 protein immunohistochemical staining is helpful in predicting the recurrence and prognosis of patients with completely resected stage 1 NSCLC," the researchers note.

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