Clinical Research
Copyright ©2006 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Apr 28, 2006; 12(16): 2549-2555
Published online Apr 28, 2006. doi: 10.3748/wjg.v12.i16.2549
Impact of lymph node micrometastasis in hilar bile duct carcinoma patients
Kentaro Taniguchi, Taku Iida, Tomohide Hori, Shintaro Yagi, Hiroshi Imai, Taizo Shiraishi, Shinji Uemoto
Kentaro Taniguchi, Taku Iida, Tomohide Hori, Shintaro Yagi, Shinji Uemoto, First Department of Surgery, Mie University School of Medicine, 2-174, Edobashi, Tsu City, Mie Prefecture, 514-8507, Japan
Hiroshi Imai, Taizo Shiraishi, Second Department of Pathology, Mie University School of Medicine, 2-174, Edobashi, Tsu City, Mie Prefecture, 514-8507, Japan
Author contributions: All authors contributed equally to the work.
Correspondence to: Kentaro Taniguchi, First 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
Telephone: +81-59-2321111 Fax: +81-59-2328095
Received: August 23, 2005
Revised: December 1, 2005
Accepted: December 7, 2005
Published online: April 28, 2006
Abstract

AIM: To immunohistochemically examine micrometastasis and VEGF-C expression in hilar bile duct carcinoma (HBDC) and to evaluate the clinical significance of the results.

METHODS: A total of 361 regional lymph nodes from 25 patients with node-negative HBDC were immunostained with an antibody against cytokeratins 8 and 18 (CAM 5.2), and immunohistochemical staining of VEGF-C was performed in 34 primary resected tumors.

RESULTS: Lymph node micrometastasis was detected in 6 (24%) of the 25 patients and 10 (2.8%) of the 361 lymph nodes. Patients with micrometastasis showed significantly poorer survival rates than those without (P = 0.025). VEGF-C expression was positive in 17 (50%) of 34 HBDC, and significantly correlated with lymph node metastasis (P = 0.042) and microscopic venous invasion (P = 0.035).

CONCLUSIONS: It is suggested that immunohistochemically detected lymph node micrometastasis has an impact on the outcome of HBDC. VEGF-C expression is highly correlated with lymph node metastasis in HBDC and might therefore be a useful predictor.

Keywords: Hilar bile duct carcinoma, Lymph node metastasis, Micrometastasis, Vascular endothelial growth factor-C