This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Mesker, W. E. Articles by Tanke, H. J. Search for Related Content PubMed PubMed Citation Articles by Mesker, W. E. Articles by Tanke, H. J.

Automated Analysis of Multiple Sections for the Detection of Occult Cells in Lymph Nodes

Laboratory for Cytochemistry and Cytometry; Department of Molecular Cell Biology [W. E. M., H. V., W. C. R. S., H. J. T.], Department of Surgery [F. S. D., R. K., R. A. E. M. T.], Department of Pathology [H. M.], Department of Medical Decision Making [G. H. d. B.], Leiden University Medical Center (LUMC), Leiden, Netherlands, and Applied Imaging International Ltd, United Kingdom [P. S. O.]

Purpose: At present, reverse transcription (RT)-PCR against carcino-embryonic antigen mRNA is one of the few research tools for the detection of occult cells in histopathologically assessed negative lymph nodes from patients with colorectal cancer. The aim of this study was to investigate the suitability of supervised low-resolution image analysis of immunohistochemically stained sections as alternative.

Experimental Design: Multiple sections (n = 50) of regional lymph nodes from patients with colorectal cancer were immunohistochemically stained and analyzed by applying low-resolution image analysis (flatbed scanning) for semiautomated detection of cytokeratin (CK)-positive stained cells. The sensitivity of this approach was demonstrated for 20 patients with stage II colorectal cancer and compared with RT-PCR regarding the detection of clinically assessed recurrence of disease within 10 years.

Results: CK⁺ cells were detected in all of the patients (n = 6; 100%) with recurrence, compared with five patients (83%) found positive by carcinoembryonic antigen RT-PCR. From patients (n = 14) who did not develop a recurrence, eight (57%) had positive lymph nodes. In all patients with recurrence, we visually identified at least one group of CK⁺ cells (2 cells).

Conclusions: Automated image analysis is a promising tool for the detection of occult cells in histopathologically negative nodes. It is potentially more sensitive but less specific for detecting recurrence of disease than conventional histopathology or RT-PCR and is particularly useful for the evaluation of sentinel nodes. Furthermore, it opens new ways for basic research of occult cells based on molecular profiling after laser-microdissection.

This article has been cited by other articles:

				W E Mesker, H Torrenga, W C R Sloos, H Vrolijk, R A E M Tollenaar, P C de Bruin, P J van Diest, and H J Tanke Supervised automated microscopy increases sensitivity and efficiency of detection of sentinel node micrometastases in patients with breast cancer J. Clin. Pathol., September 1, 2004; 57(9): 960 - 964. [Abstract] [Full Text] [PDF]