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A greater lymph node yield is required during pathological examination in microsatellite instability-high gastric cancer
BACKGROUND: The impact of microsatellite status on lymph node (LN) yield during lymphadenectomy and pathological examination has never been assessed in gastric cancer (GC). In this study, we aimed to appraise the association between microsatellite instability-high (MSI-H) and LN yield after curative...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7992823/ https://www.ncbi.nlm.nih.gov/pubmed/33765970 http://dx.doi.org/10.1186/s12885-021-08044-8 |
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author | Cai, Zhenghao Song, Haiqin Fingerhut, Abe Sun, Jing Ma, Junjun Zhang, Luyang Li, Shuchun Yu, Chaoran Zheng, Minhua Zang, Lu |
author_facet | Cai, Zhenghao Song, Haiqin Fingerhut, Abe Sun, Jing Ma, Junjun Zhang, Luyang Li, Shuchun Yu, Chaoran Zheng, Minhua Zang, Lu |
author_sort | Cai, Zhenghao |
collection | PubMed |
description | BACKGROUND: The impact of microsatellite status on lymph node (LN) yield during lymphadenectomy and pathological examination has never been assessed in gastric cancer (GC). In this study, we aimed to appraise the association between microsatellite instability-high (MSI-H) and LN yield after curative gastrectomy. METHODS: We retrospectively analyzed 1757 patients with GC undergoing curative gastrectomy and divided them into two groups: MSI-H (n = 185(10.5%)) and microsatellite stability (MSS) (n = 1572(89.5%)), using a five-Bethesda-marker (NR-24, BAT-25, BAT-26, CAT-25, MONO-27) panel. The median LN count and the percentage of specimens with a minimum of 16 LNs (adequate LN ratio) were compared between the two groups. The log odds (LODDS) of positive LN count (PLNC) to negative LN count (NLNC) and the target LN examined threshold (TLNT((x%))) were calculated in both groups. RESULTS: Statistically significant differences were found in the median LN count between MSI-H and MSS groups for the complete cohort (30 vs. 28, p = 0.031), for patients undergoing distal gastrectomy (DG) (30 vs. 27, p = 0.002), for stage II patients undergoing DG (34 vs. 28, p = 0.005), and for LN-negative patients undergoing DG (28 vs. 24, p = 0.002). MSI-H was an independent factor for higher total LN count in patients undergoing DG (p = 0.011), but it was not statistically correlated to the adequate LN ratio. Statistically significant differences in PLNC, NLNC and LODDS were found between MSI-H GC and MSS GC (all p < 0.001). The TLNT((90%)) for MSI-H and MSS groups were 31 and 25, respectively. TLNT((X%)) of MSI-H GC was always higher than that of MSS GC regardless of the given value of X%. CONCLUSIONS: MSI-H was associated with higher LN yield in patients undergoing gastrectomy for GC. Although MSI-H did not affect the adequacy of LN harvest, we speculate that a greater lymph node yield is required during pathological examination in MSI-H GC. |
format | Online Article Text |
id | pubmed-7992823 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-79928232021-03-25 A greater lymph node yield is required during pathological examination in microsatellite instability-high gastric cancer Cai, Zhenghao Song, Haiqin Fingerhut, Abe Sun, Jing Ma, Junjun Zhang, Luyang Li, Shuchun Yu, Chaoran Zheng, Minhua Zang, Lu BMC Cancer Research Article BACKGROUND: The impact of microsatellite status on lymph node (LN) yield during lymphadenectomy and pathological examination has never been assessed in gastric cancer (GC). In this study, we aimed to appraise the association between microsatellite instability-high (MSI-H) and LN yield after curative gastrectomy. METHODS: We retrospectively analyzed 1757 patients with GC undergoing curative gastrectomy and divided them into two groups: MSI-H (n = 185(10.5%)) and microsatellite stability (MSS) (n = 1572(89.5%)), using a five-Bethesda-marker (NR-24, BAT-25, BAT-26, CAT-25, MONO-27) panel. The median LN count and the percentage of specimens with a minimum of 16 LNs (adequate LN ratio) were compared between the two groups. The log odds (LODDS) of positive LN count (PLNC) to negative LN count (NLNC) and the target LN examined threshold (TLNT((x%))) were calculated in both groups. RESULTS: Statistically significant differences were found in the median LN count between MSI-H and MSS groups for the complete cohort (30 vs. 28, p = 0.031), for patients undergoing distal gastrectomy (DG) (30 vs. 27, p = 0.002), for stage II patients undergoing DG (34 vs. 28, p = 0.005), and for LN-negative patients undergoing DG (28 vs. 24, p = 0.002). MSI-H was an independent factor for higher total LN count in patients undergoing DG (p = 0.011), but it was not statistically correlated to the adequate LN ratio. Statistically significant differences in PLNC, NLNC and LODDS were found between MSI-H GC and MSS GC (all p < 0.001). The TLNT((90%)) for MSI-H and MSS groups were 31 and 25, respectively. TLNT((X%)) of MSI-H GC was always higher than that of MSS GC regardless of the given value of X%. CONCLUSIONS: MSI-H was associated with higher LN yield in patients undergoing gastrectomy for GC. Although MSI-H did not affect the adequacy of LN harvest, we speculate that a greater lymph node yield is required during pathological examination in MSI-H GC. BioMed Central 2021-03-25 /pmc/articles/PMC7992823/ /pubmed/33765970 http://dx.doi.org/10.1186/s12885-021-08044-8 Text en © The Author(s) 2021 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Article Cai, Zhenghao Song, Haiqin Fingerhut, Abe Sun, Jing Ma, Junjun Zhang, Luyang Li, Shuchun Yu, Chaoran Zheng, Minhua Zang, Lu A greater lymph node yield is required during pathological examination in microsatellite instability-high gastric cancer |
title | A greater lymph node yield is required during pathological examination in microsatellite instability-high gastric cancer |
title_full | A greater lymph node yield is required during pathological examination in microsatellite instability-high gastric cancer |
title_fullStr | A greater lymph node yield is required during pathological examination in microsatellite instability-high gastric cancer |
title_full_unstemmed | A greater lymph node yield is required during pathological examination in microsatellite instability-high gastric cancer |
title_short | A greater lymph node yield is required during pathological examination in microsatellite instability-high gastric cancer |
title_sort | greater lymph node yield is required during pathological examination in microsatellite instability-high gastric cancer |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7992823/ https://www.ncbi.nlm.nih.gov/pubmed/33765970 http://dx.doi.org/10.1186/s12885-021-08044-8 |
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