Background: The regional lymph node involvement is a major prognostic factor in patients with non-small cell\nlung cancer (NSCLC) undergoing surgical resection. Disease relapse is common, suggesting that early disseminated\ndisease is already present in the regional lymph nodes at the time of surgery, and that the current nodal staging\nclassification might be suboptimal. Early detection of disseminated tumor cells (DTCs) in lymph nodes could\npotentially enable identification of subcategories of patients with high risk of disease relapse.\nMethod: Lymph node samples were collected from 128 NSCLC patients at the time of surgery and the presence of\nDTCs determined by immunomagnetic selection (IMS) using the MOC31 antibody recognizing EpCAM. Results\nobtained with IMS were compared to the pathological staging obtained by histopathology. Associations between\nthe presence of DTCs and clinicopathological variables and patient outcome were investigated.\nResults: DTCs were detected in 40 % of the lymph node samples by IMS. Their presence was significantly\nassociated with pN status as assessed by histopathology, and samples from 83 % of the patients with lymph\nnode metastases (pN1-2) had detectable DTCs. In the group of patients who were negative for lymph node\nmetastases by standard histopathology (pN0) DTCs were detected in 32 %. The presence of DTCs was not\nassociated with any other clinicopathological variables. Patients with IMS-positive samples showed decreased\nrelapse free survival compared to patients with IMS-negative samples, but the difference was not statistically\nsignificant. The pN status was significantly associated with both relapse free and overall survival, but the\npresence of DTCs had no prognostic impact in the subcategory of patients with pN0 status.\nConclusion: Our findings do not support further development of lymph node DTC detection for clinical use\nin early stage NSCLC.
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