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Detection of micrometastases in lymph nodes using reverse transcription polymerase chain reaction (RT-PCR) for cytokeratin 20 (CK-20) – a pilot study

Authors:

SRE Wijesuriya ,

Department of Surgery, University of Kelaniya, LK
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KGR Kuruppuarachchi,

Department of Molecular Biology, Medical Research Institute, Colombo, LK
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A Weerasinghe,

Department of Physiology, University of Kelaniya, LK
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J Hewavisenthi,

Department of Pathology, University of Kelaniya, LK
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KI Deen

Department of Surgery, University of Kelaniya, LK
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Abstract

Objectives The aim of the study was to detect micrometastases in lymph nodes in patients with rectal cancer following neoadjuvant therapy, staged node negative by routine histology.

Patients and setting Mesenteric lymph nodes from patients who have undergone neoadjuvant therapy for rectal cancer were harvested during surgery. Nodes were bisected and one half was sent for haematoxylin and eosin (H&E) staining and evaluated by a single pathologist. The other half was examined for CK20 by RT-PCR. The technique was validated by testing mesenteric lymph nodes with known metastases and nodes from patients without cancer. Twenty one lymph nodes from 6 patients (median age 46 years, range 25- 55) which were negative for tumour deposits by H&E stain were assessed for micro-metastases.

Results All 21 nodes which were histologically negative for metastases were positive for micrometastases. Two nodes with known metastases were positive for CK20 and 3 nodes from non cancer patients were negative for CK20.

Conclusions Detection of CK20 is accurate in identification of rectal cancer micro-metastasing to lymph nodes. Assessment of nodes by H & E histology risks under staging.

Index words: neoadjuvant therapy; rectal cancer; lymph nodes

DOI: 10.4038/cmj.v55i3.2290

Ceylon Medical Journal 2010; 55: 77-9

DOI: https://doi.org/10.4038/cmj.v55i3.2290
How to Cite: Wijesuriya, S., Kuruppuarachchi, K., Weerasinghe, A., Hewavisenthi, J. and Deen, K., 2010. Detection of micrometastases in lymph nodes using reverse transcription polymerase chain reaction (RT-PCR) for cytokeratin 20 (CK-20) – a pilot study. Ceylon Medical Journal, 55(3), pp.77–79. DOI: http://doi.org/10.4038/cmj.v55i3.2290
Published on 27 Sep 2010.
Peer Reviewed

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