대한대장항문학회

Purpose : Lymph node metastasis is the most important prognostic factor in colorectal<br>cancer. However, 20∼30% of patients with lymph node negative colorectal cancer die of<br>recurrent disease. We investigated whether the detection of micrometastasis is of any clinical<br>significance in Dukes' stage A & B colorectal cancer. Methods : Ninety patients who<br>underwent curative resection of colorectal cancer from Aug. of 1996 to Jan. of 1999 were<br>entered the study. For examination, we used paraffin blocks of lymph nodes which were<br>metastasis-free by conventional histopathology. After preparation of tissue blocks using the<br>serial sectioning technique, the specimens were stained with immunohistochemical method<br>using anticytokeratin antibody. And the hematoxylin-eosin staining was repeated. Results :<br>We disclosed micrometastases in 15 of 90 cases, mostly located in subcapsular sinuses. And<br>in 8 of 15 cases, we also found metastases in repeated H&E staining. There were no<br>significant relationship between the detection of micrometastases and the depth of wall<br>invasion, the histological grade and the status of lymphovascular invasion. With median<br>follow-up of 15 months, we found no significant difference in recurrence between the<br>micrometasis positive and negative groups. Conclusions : The result showed that the<br>micrometastasis of lymph node in colorectal caner might increase the risk for development of<br>tumor recurrence. But because of small numbers of recurrent cases and relatively short<br>follow-up period, there was no statistically significant relationship between micrometastasis<br>negative and positive groups.<br>