Metastatic Status of Lymphnodes from Radical Surgical Resections: Role of Cytokeratin as an Adjuvant to Standard Staining Method

Aiswarya Nivedhitha, S (2020) Metastatic Status of Lymphnodes from Radical Surgical Resections: Role of Cytokeratin as an Adjuvant to Standard Staining Method. Masters thesis, Tirunelveli Medical College, Tirunelveli.

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Abstract

BACKGROUND: Even after curative surgical resection of an early cancer, some patients get recurrence and die of cancer. So it is our view that those with an early stage of malignancy and died, might have got occult metastasis in their nodes. Those occult metastases can be identified using IHC with epithelial markers such as cytokeratin. OBJECTIVE: To determine the effectiveness of immunohistochemistry (Pan cytokeratin) as an adjuvant in detecting occult metastasis in lymph nodes. METHODS: Study material includes cases of radical resections diagnosed as malignancy. Among the cases, 50 cases which were diagnosed as epithelial malignancies on H&E were separated and chosen for study. Grading was performed, followed by TNM staging was done. And the nodes which were negative for metastasis, were taken for immunohistochemistry. The observations were recorded, compared and analyzed. RESULTS: Out of 498 nodes, 54 nodes are detected as positive for metastasis by H&E, whereas additional 14 nodes are detected as positive for metastasis by pan cytokeratin method. Among 50 cases studied, TNM stage is modified for 6 cases, among which 4/20 cases of breast malignancies (1/2 of invasive lobular carcinoma, 3/18 of invasive ductal carcinoma) and 2/8 cases of gastric malignancies. CONCLUSIONS: A routine screening of lymph nodal slides with Pan ck – IHC could highlight the nodal status exactly as an occult metastasis are readily identified. It leads to categorise the additional metastatic nodal load, so that improved therapeutic decision can be made.

Item Type: Thesis (Masters)
Additional Information: 201713301
Uncontrolled Keywords: Immunohistochemistry, epithelial malignancy, occult metastasis, pan cytokeratin.
Subjects: MEDICAL > Pathology
Depositing User: Subramani R
Date Deposited: 29 Jan 2021 16:55
Last Modified: 29 Jan 2021 16:55
URI: http://repository-tnmgrmu.ac.in/id/eprint/13414

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