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Immunohistologic detection of prostate cancer pelvic lymph node micrometastases: correlation to preoperative serum prostate-specific antigen.

Publication ,  Journal Article
Moul, JW; Lewis, DJ; Ross, AA; Kahn, DG; Ho, CK; McLeod, DG
Published in: Urology
January 1994

OBJECTIVE: To test the hypothesis that prostate cancer lymph node (LN) micrometastases, undetected by standard histology, might be found using sensitive immunohistologic methods and may correlate to preoperative prostate-specific antigen (PSA) levels. METHOD: Archival paraffin blocks of pelvic lymphadenectomy specimens from radical prostatectomy were blindly submitted for immunostaining using pan-cytokeratin monoclonal antibody SB-3, as well as antibodies directed against PSA. Automated immunostaining was performed on a Ventana Medical Systems 320 immunostainer. As a positive control, 7 cases with known nodal metastases by standard histology were blindly analyzed and all has detectable micrometastases by this methodology. RESULTS: For 13 patients with PSA < 10.1 (8%) had LN micrometastases detected. For 10 patients with PSA between 10 and 20 and for 9 patients with PSA > 20, no occult metastases were detected. We did find previously undetected prostate cancer (CaP) LN micrometastases in 1 of 32 (3%) clinically localized prostate cancer patients who had undergone radical prostatectomy. In many LNs, cytokeratin stains cross-reacted and stained individual plasma cells, whereas in the positive metastatic case, a cluster/nest of CaP cells were reactive. To the unfamiliar observer, the pitfall of false-positive results because of nonspecific cytokeratin staining must be considered. These results are in exact agreement with another recent study which also found only a 3 percent incidence of unsuspected pelvic lymph node micrometastases in clinically localized CaP utilizing similar methods. CONCLUSIONS: Our hypothesis was not substantiated: LN micrometastases were uncommon and did not correlate to serum PSA. Unlike studies with breast cancer, occult micrometastatic nodal disease not appreciated by standard methods appears to be uncommon in clinically localized prostatic carcinoma.

Duke Scholars

Published In

Urology

DOI

ISSN

0090-4295

Publication Date

January 1994

Volume

43

Issue

1

Start / End Page

68 / 73

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Prostatic Neoplasms
  • Prostate-Specific Antigen
  • Preoperative Care
  • Pelvis
  • Male
  • Lymphatic Metastasis
  • Immunohistochemistry
  • Humans
  • 3202 Clinical sciences
 

Citation

APA
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ICMJE
MLA
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Moul, J. W., Lewis, D. J., Ross, A. A., Kahn, D. G., Ho, C. K., & McLeod, D. G. (1994). Immunohistologic detection of prostate cancer pelvic lymph node micrometastases: correlation to preoperative serum prostate-specific antigen. Urology, 43(1), 68–73. https://doi.org/10.1016/s0090-4295(94)80267-x
Moul, J. W., D. J. Lewis, A. A. Ross, D. G. Kahn, C. K. Ho, and D. G. McLeod. “Immunohistologic detection of prostate cancer pelvic lymph node micrometastases: correlation to preoperative serum prostate-specific antigen.Urology 43, no. 1 (January 1994): 68–73. https://doi.org/10.1016/s0090-4295(94)80267-x.
Moul, J. W., et al. “Immunohistologic detection of prostate cancer pelvic lymph node micrometastases: correlation to preoperative serum prostate-specific antigen.Urology, vol. 43, no. 1, Jan. 1994, pp. 68–73. Pubmed, doi:10.1016/s0090-4295(94)80267-x.
Journal cover image

Published In

Urology

DOI

ISSN

0090-4295

Publication Date

January 1994

Volume

43

Issue

1

Start / End Page

68 / 73

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Prostatic Neoplasms
  • Prostate-Specific Antigen
  • Preoperative Care
  • Pelvis
  • Male
  • Lymphatic Metastasis
  • Immunohistochemistry
  • Humans
  • 3202 Clinical sciences