HISTOPATHOLOGICAL ASSESSMENT OF LYMPH-NODE METASTASIS IN PATIENTS WITH GASTRIC-CANCER

Background/Aims: Lymph node dissection has been. carried out for two d ecades in Japan, resulting in improved survival of patients with gastr ic cancer. By analyzing dissected nodes of resected advanced gastric c ancers, we intend to determine which parameter(s) are more concerned i n node metastasis. Patients and Methods: Curative gastrectomy with dis section of lymph nodes was performed for 78 of the 108 patients with a dvanced gastric cancer. Metastases were found in 171 of 1359 nodes (13 %) dissected. In each node, the maximum and minimum diameters were mea sured, and the ratio of the former to the latter was calculated Result s: The minimum diameter of node was closely related to node metastasis . When the minimum diameter in node metastatic criteria was ''3 mm or more'', a sensitivity of 81% and specificity of 54% were calculated. I n false negative node, signet-ring cell carcinoma (SIG) (33%) and poor ly differentiated adenocarcinoma (FOR) (22%) were more frequently foun d as primary Lesions. Half or more of these nodes were invaded by only a few carcinoma cells. When the primary lesion is histologically SIG or FOR, endoscopic treatment is contraindicated for possible nodes met astasis. Conclusions: It is impossible to distinguish nodes with micro metastasis from nodes without metastasis. The minimum diameter of node is more important in node metastasis of gastric cancer than the maxim um diameter;if node or the ratio of both.