Burt Cagir, MD; Alyssa Gelmann, MD; Jason Park, BS; Tracy Fava, BS; Alexander Tankelevitch, MD; Edwin W. Bittner, MD; Eric J. Weaver, MD, PhD; Juan P. Palazzo, MD; David Weinberg, MD, MSc; Robert D. Fry, MD; Scott A. Waldman, MD, PhD
Cagir B, Gelmann A, Park J, Fava T, Tankelevitch A, Bittner EW, et al. Guanylyl Cyclase C Messenger RNA Is a Biomarker for Recurrent Stage II Colorectal Cancer. Ann Intern Med. 1999;131:805-812. doi: 10.7326/0003-4819-131-11-199912070-00002
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Published: Ann Intern Med. 1999;131(11):805-812.
Stage at diagnosis is the most important prognostic determinant for patients with colorectal cancer (1-6), and it dictates the role of adjuvant chemotherapy in this disease (7-10). Given the prognostic and therapeutic importance of staging, accurate histopathologic evaluation of lymph nodes to detect invasion by tumor cells is crucial. However, conventional microscopic lymph node examination has methodologic limitations (6, 11). It can be difficult to differentiate single or even small clumps of tumor cells from other types of cells, which limits sensitivity. The standard practice of examining only a limited number of tissue sections from each lymph node can omit from review more than 99% of each specimen and can introduce sampling error. These limitations are evident when the frequency of disease recurrence in patients with stage I and stage II disease is considered. By definition, such patients do not have extraintestinal disease at the time of curative resection. However, recurrence rates of 10% to 30% have been reported for lesions confined to the mucosa (stage I disease), and rates of 30% to 50% have been reported for lesions confined to the bowel wall (stage II disease) (12, 13).
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Gastroenterology/Hepatology, Hematology/Oncology, Gastrointestinal Cancer, Colorectal Cancer.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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