Significato biologico delle micrometastasi linfonodali e midollari nel carcinoma esofageo

The aim of the study was to test the hypothesis that a subgroup of patients considered N0 at standard single-section pathological examination may have occult lymph-node metastases (micrometastases) associated with a poor prognosis. Fifty-nine patients with oesophageal adenocarcinoma undergoing resection were studied by standard histological examinations, serial sections and immunohistochemistry, and their long-term prognoses were compared. Eight (26%) out of 31 patients previously staged as pN0 at standard histological examination were staged as pN1 or Pn2 by serial sections and/or immunohistochemistry and had a prognosis which was significantly worse than that of true pN0 patients (5-year survival: 38% vs 76%, respectively; P < 0.05) and similar to that of pN1 patients. More than a quarter of those patients classified as pN0 at standard histological examination may have occult lymph node metastases at serial sections and/or immunohistochemistry and have a prognosis similar to that of pN1 patients.