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Detection of occult N2 disease with molecular techniques.

Publication ,  Journal Article
Erhunmwunsee, L; D'Amico, TA
Published in: Thorac Surg Clin
November 2008

Lymph node involvement is the most important factor affecting the prognosis and treatment of patients with potentially resectable NSCLC. Radiographic imaging is inadequate to ascertain lymph node involvement accurately. Currently, lymph nodes are histologically examined with standard histopathologic techniques, such as H&E staining; however, lymph node micrometastases (occult N2 disease) may be missed, leading to inaccurate staging and suboptimal treatment. More accurate strategies, using molecular biologic techniques, are currently being studied. IHC using antibodies to cytokeratins improves the sensitivity of lymph node assessment. Other techniques, such as RT-PCR, may be superior to IHC, and the detection of various cancer-specific gene transcripts by RT-PCR is being evaluated. Many transcripts with high sensitivity also demonstrate low specificity, either because of their presence in non-neoplastic tissue or (as is the case of CK-19) because of the existence of associated pseudogenes. At the present time, the most promising molecular detector may be KS1/4, which is infrequently present in noncancerous cells but has a high sensitivity in metastatic nodes. Genomic analysis of lymph nodes, which may be used to improve the detection of micrometastases and to improve risk stratification, is currently being studied. Genomic signatures have the potential to guide therapeutic decision making as well.

Duke Scholars

Published In

Thorac Surg Clin

DOI

ISSN

1547-4127

Publication Date

November 2008

Volume

18

Issue

4

Start / End Page

339 / 347

Location

United States

Related Subject Headings

  • Reverse Transcriptase Polymerase Chain Reaction
  • Respiratory System
  • Molecular Diagnostic Techniques
  • Mediastinum
  • Lymphatic Metastasis
  • Lymph Nodes
  • Lung Neoplasms
  • Humans
  • Epithelial Cell Adhesion Molecule
  • Cell Adhesion Molecules
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Erhunmwunsee, L., & D’Amico, T. A. (2008). Detection of occult N2 disease with molecular techniques. Thorac Surg Clin, 18(4), 339–347. https://doi.org/10.1016/j.thorsurg.2008.07.001
Erhunmwunsee, Loretta, and Thomas A. D’Amico. “Detection of occult N2 disease with molecular techniques.Thorac Surg Clin 18, no. 4 (November 2008): 339–47. https://doi.org/10.1016/j.thorsurg.2008.07.001.
Erhunmwunsee L, D’Amico TA. Detection of occult N2 disease with molecular techniques. Thorac Surg Clin. 2008 Nov;18(4):339–47.
Erhunmwunsee, Loretta, and Thomas A. D’Amico. “Detection of occult N2 disease with molecular techniques.Thorac Surg Clin, vol. 18, no. 4, Nov. 2008, pp. 339–47. Pubmed, doi:10.1016/j.thorsurg.2008.07.001.
Erhunmwunsee L, D’Amico TA. Detection of occult N2 disease with molecular techniques. Thorac Surg Clin. 2008 Nov;18(4):339–347.
Journal cover image

Published In

Thorac Surg Clin

DOI

ISSN

1547-4127

Publication Date

November 2008

Volume

18

Issue

4

Start / End Page

339 / 347

Location

United States

Related Subject Headings

  • Reverse Transcriptase Polymerase Chain Reaction
  • Respiratory System
  • Molecular Diagnostic Techniques
  • Mediastinum
  • Lymphatic Metastasis
  • Lymph Nodes
  • Lung Neoplasms
  • Humans
  • Epithelial Cell Adhesion Molecule
  • Cell Adhesion Molecules