Clinical necessity of the immunohistochemical reassessment of para‑aortic lymph nodes in resected pancreatic ductal adenocarcinoma

Choi,Sung Hoon; Kim,Se Hoon; Choi,Jun Jeong; Kang,Chang Moo; Hwang,Ho Kyoung; Lee,Woo Jung

doi:10.3892/ol.2013.1539

Clinical necessity of the immunohistochemical reassessment of para‑aortic lymph nodes in resected pancreatic ductal adenocarcinoma

Authors:
- Sung Hoon Choi
- Se Hoon Kim
- Jun Jeong Choi
- Chang Moo Kang
- Ho Kyoung Hwang
- Woo Jung Lee
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Affiliations: Department of Surgery, Yonsei University College of Medicine, Seoul 120-752, South Korea, Department of Pathology, Yonsei University College of Medicine, Seoul 120-752, South Korea, Department of Pathology, Yonsei University Wonju College of Medicine, Wonju 220-050, South Korea
Published online on: August 21, 2013 https://doi.org/10.3892/ol.2013.1539
Pages: 1189-1194

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Abstract

Para‑aortic lymph node (PALN) metastasis is widely regarded as a systemic disease in cancer. Undetected PALN micrometastases during routine hematoxylin and eosin (HE) staining may be a cause of poor prognosis following a potentially curative pancreatectomy for pancreatic cancer. In the present study, paraffin‑embedded PALN tissue blocks from 99 patients who underwent a pancreatectomy were re‑evaluated by immunohistochemical staining using cytokeratin (CK)‑19. Patients with PALN metastasis were summarized according to the clinicopathological data. A total of 484 PALNs (median, 4.9 nodes per patient; range, 1‑19) were evaluated. PALN metastases were revealed in eight patients (8.1%) by routine HE staining of frozen section biopsies and in one patient (1.0%) by HE staining of a permanent section. Only one patient (1.0%) demonstrated micrometastasis by IHC; this patient did not display any adverse pathological characteristics and had a relatively favorable survival period of 41 months. The present study concluded that an additional reassessment for micrometastasis in PALNs using CK‑19 immunohistochemistry (IHC) is not a viable method for determining the survival outcome. A careful examination of a frozen section biopsy is sufficient for attempting curative surgery.

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