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Molecular quantification and mapping of lymph-node micrometastases in cervical cancer

Van Trappen, PO; Gyselman, VG; Lowe, DG; Ryan, A; Oram, DH; Bosze, P; Weekes, AR; ... Jacobs, IJ; + view all (2001) Molecular quantification and mapping of lymph-node micrometastases in cervical cancer. LANCET , 357 (9249) 15 - 20.

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Abstract

Background A proportion of patients with cancer and lymph nodes negative on histology will develop recurrence. Reverse-transcriptase PCR (RT-PCR) is a highly sensitive method for detection of lymph-node micrometastases, but accurate quantitative assessment has been difficult.Methods We studied primary tumours and 156 lymph nodes from 32 patients with cervical cancer (stage IA2, IB1, and 1B2) and 32 lymph nodes from nine patients with benign disease. A fully quantitative, real-time RT-PCR assay was used to document absolute copy numbers of the epithelial marker cytokeratin 19. Primers and probe were designed not to amplify either of the two cytokeratin 19 pseudogenes.Findings All primary tumours and histologically involved lymph nodes (six) had more than 10(6) copies of cytokeratin 19 mRNA per mug total RNA. Expression of cytokeratin 19 (up to 1.1x10(5) copies per mug RNA) was detected in 66 (44%) of 150 histologically uninvolved lymph nodes, and in nodes from 16 of 32 patients with cervical cancer. 15 of these 16 patients with evidence of micrometastases had the highest cytokeratin 19 transcription level in a first lymph-node drainage-station (three obturator, six internal, and six external iliac node). Transcription of cytokeratin 19 was found at a low level in just one of 32 lymph nodes obtained from nine patients with benign disease. Median copy number of cytokeratin 19 transcription was significantly higher (>10(3) copies) in association with adverse prognostic features.Interpretation The results suggest that about 50% of early-stage cervical cancers shed tumour cells to the pelvic lymph nodes. The amount of cytokeratin 19 expression was related to clinicopathological features. Further studies are required to document the clinical implications of molecular micrometastases.

Type: Article
Title: Molecular quantification and mapping of lymph-node micrometastases in cervical cancer
Keywords: POLYMERASE-CHAIN-REACTION, BREAST-CANCER, COLORECTAL-CANCER, REVERSE-TRANSCRIPTASE, PERIPHERAL-BLOOD, MESSENGER-RNA, CELLS, METASTASIS, CARCINOMA, IDENTIFICATION
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Inst for Women's Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Inst of Clinical Trials and Methodology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Inst of Clinical Trials and Methodology > MRC Clinical Trials Unit at UCL
URI: http://discovery.ucl.ac.uk/id/eprint/8175
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