Prognostic value of isolated tumor cells and micrometastasis of lymph nodes in invasive urinary bladder cancer.

Autor: Cheong H; Department of Forensic Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea., Yoo Y; Department of Pathology, Ewha Womans University Seoul Hospital, Seoul, Republic of Korea., Sung SH; Department of Pathology, Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea., Park S; Department of Pathology, Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea., Lee DH; Department of Urology, Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea., Kong KA; Department of Preventive Medicine, Ewha Womans University College of Medicine, Seoul, Republic of Korea., Park HS; Department of Pathology, Ewha Womans University Seoul Hospital, Seoul, Republic of Korea., Cho MS; Department of Pathology, Ewha Womans University Seoul Hospital, Seoul, Republic of Korea.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2024 Oct 25; Vol. 19 (10), pp. e0302445. Date of Electronic Publication: 2024 Oct 25 (Print Publication: 2024).
DOI: 10.1371/journal.pone.0302445
Abstrakt: Introduction: The prognostic significance of nodal micrometastasis and isolated tumor cells (ITC) in urinary bladder cancer (UBC) is unknown. We aimed to evaluate the prevalence, clinical impact, and clinicopathological characteristics of nodal micrometastasis and ITC in UBC.
Materials and Methods: A total of 124 patients with UBC undergoing surgery were investigated. Detection of micrometastasis and ITC was performed using pancytokeratin immunohistochemistry (IHC). Histopathologic and clinical findings were correlated with patients' outcome.
Result: IHC detected nodal micrometastasis and ITC (pNmi group) in 12.9% (13/101) of originally node-negative patients and in 26.1% (6/23) of originally node-positive patients (pN+ group). The remaining 88 were truly node-negative patients (pN0 group). After IHC, all 13 patients in the pNmi group were upstaged from pN0 to pN1-2 and one patient in the pN+ group was changed from pN1 to pN2. Nodal micrometastasis and ITC were significantly associated with mixed urothelial carcinoma (UC) (p = 0.002), UC with discohesive pattern (p = 0.006), glandular differentiation (p = 0.043), lymphovascular invasion (p = 0.009), and budding-like tumor cell clusters (p = 0.002). The pNmi group had significantly worse cancer-specific survival than the pN0 group in univariate (p = 0.004) and multivariate (p = 0.040) analysis.
Conclusion: IHC frequently identified nodal micrometastasis and ITC in originally node-negative UBC patients on routine pathological examination. Nodal micrometastasis and ITC were independently associated with cancer-related mortality in UBC. IHC might be selectively used to detect micrometastasis and ITC in UBC having specific pathological features.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2024 Cheong et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze: MEDLINE
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