The Detection Of Lymph Node Micrometastasis In Bladder Urothelial Cancer And The Influence Of Micrometastasis On Patients, Prognosis

Objective: To evaluate the probability and impact factors of lymph nodemicrometastasis(LNM) in patients with bladder urothelial cancer(PT1-4N0M0),andinvestigate the relationship between LNM and5-year survival rate.Methods：128bladder cancer patients followed up for7to112months after radicalcystectomy were enrolled. The expression of Uroplakin Ⅱ (UP Ⅱ) andCytokeratin20(CK20)were examined in lymph nodes by SP immunohistochemistry aftersurgical lymphadenectomy. The relationship between clinical parameters, pathologicparameters and UPⅡ, CK20expression was analyzed.The difference of5-year survivalrates between patients with and without LNM was statistically analyzed.Results：39cases found positively stained lymph nodes which suggested LNM.Immunohistochemical analysis of25cases was positive for UPⅡ,and immunohistochemicalanalysis of24cases was positive for CK20. Combined method with UPⅡ and CK20couldenhance the detection rate of LNM. LNM of bladder cancer was statistically associated withpathological stage and grade(P<0.05) rather than patients,age, gender and tumor size,number. The5-year survival rates in patients with and without LNM were41.03%and68.54%, the difference was statistically significant(P<0.01).Conclusion：Immunohistochemical method combined with UPⅡ and CK20can enhancethe detection rate of LNM for bladder cancer. Patients with high tumor stage(T3-4) or grade(G3)are easily to emerge LNM. The patients with LNM always have a poor prognosis.