Transcription-reverse transcription concerted reaction and minimal residual disease in axillary sentinel nodes of breast cancer

Ishikawa, T.; Miyajima, E.; Sasaki, T.; Tanabe, M.; Matsumoto, C.; Nozawa, A.; Kawachi, K.; Fukuno, Y.; Takeda, H.; Hayashi, T.; Onaka, S.; Momiyama, N.; Ichikawa, Y.; Inui, K.; Shimada, H.

doi:10.1016/j.ejso.2006.09.038

« Previous Next »European Journal of Surgical Oncology
Volume 33, Issue 4 , Pages 430-434, May 2007

Transcription-reverse transcription concerted reaction and minimal residual disease in axillary sentinel nodes of breast cancer

T. Ishikawa
- Department of General Surgery, Yokohama City University Medical Center, 4–57, Urafune-cho, Minami-ku, Yokohama 232-0024, Japan
- Corresponding author. Tel.: +81 45 253 5367; fax: +81 45 261 9492.
E. Miyajima
- Department of Laboratory Medicine and Clinical Investigation, Yokohama City University Medical Center, Yokohama, Japan
T. Sasaki
- Department of Pathology, Yokohama City University Medical Center, Yokohama, Japan
M. Tanabe
- Department of General Surgery, Yokohama City University Medical Center, 4–57, Urafune-cho, Minami-ku, Yokohama 232-0024, Japan
C. Matsumoto
- Department of General Surgery, Yokohama City University Medical Center, 4–57, Urafune-cho, Minami-ku, Yokohama 232-0024, Japan
A. Nozawa
- Department of Pathology, Yokohama City University Medical Center, Yokohama, Japan
K. Kawachi
- Department of Pathology, Yokohama City University Medical Center, Yokohama, Japan
Y. Fukuno
- Department of Laboratory Medicine and Clinical Investigation, Yokohama City University Medical Center, Yokohama, Japan
H. Takeda
- Department of Laboratory Medicine and Clinical Investigation, Yokohama City University Medical Center, Yokohama, Japan
T. Hayashi
- Tosoh Cooperation, 2743-1, Hayakawa, Ayase, Kanagawa 252-1123, Japan
S. Onaka
- Tosoh Cooperation, 2743-1, Hayakawa, Ayase, Kanagawa 252-1123, Japan
N. Momiyama
- Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, 3–9, Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan
Y. Ichikawa
- Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, 3–9, Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan
K. Inui
- Department of General Surgery, Yokohama City University Medical Center, 4–57, Urafune-cho, Minami-ku, Yokohama 232-0024, Japan
H. Shimada
- Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, 3–9, Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan

Accepted 29 September 2006.

Abstract

Aims

To investigate the use of transcription-reverse transcription concerted reaction (TRC) to detect axillary lymph node metastases.

Methods

Metastases in 423 lymph nodes obtained from 50 breast cancer patients were investigated by routine pathological hematoxylin and eosin (H&E) staining and quantitative analysis of carcinoembryonic antigen (CEA) mRNA by TRC. Enhanced pathological studies, serial sectioning and immunohistochemistry were conducted for cases which were negative by routine pathology, but positive by TRC.

Results

Pathological examination identified metastatic disease in 67 lymph nodes. TRC CEA mRNA results were concordant with 89.8% of these cases at a threshold of 100 copies. TRC identified 30 false negative nodes, which was reduced to 15 by excluding node biopsies yielding less than 40μg total RNA. Twelve nodes were histologically negative for cancer, but positive according to TRC. Serial sectioning and immunohistochemical analysis of these nodes revealed macrometastatic lesions in three, micrometastasis in one, and isolated tumor cells in two.

Conclusion

TRC for the detection of CEA mRNA may complement routine pathological examination by sentinel lymph node biopsy (SNB) in early breast cancer. We have started an enhanced pathological examination with serial sectioning on all excised sentinel nodes to set the best threshold for the TRC method.

Keywords: Histology, Laboratory techniques and procedures, Molecular biology, Neoplasms, Pathology, Surgery