Investigation of micrometastasis in apical lymph nodes in colorectal cancers and correlation of the results with VEGF-c values in tumor cells

INTRODUCTION AND AIM: This prospective study aimed to screen the dissected apical lymph nodes for micrometastasis and compare them with VEGF values in tumor cells in patients operated for colorectal cancer. METHOD: Patients operated with the diagnosis of colorectal cancer between January 2021 and July 2022 will be prospectively evaluated. After routine histochemical examinations of these patients, immunohistochemical staining with pancitokeratin will be performed for the evaluation of apical lymph node micrometastasis. Primary tumor cells will also be immunohistochemically stained with VEGF-c. Expression levels will be recorded. Correlation between apical lymph node micrometastasis and primary tumor VEGF-c levels will be investigated. RESULTS: Apical lymph node metastasis was detected in 8 patients in the evaluation of 112 patients operated for colorectal cancer. Immunohistochemical staining revealed micrometastasis in the apical lymph node in 1 patient. While 85.7% (n=96) of the patients had a VEGF density score of 3, 40.2% (n=45) had a VEGF prevalence score of 3.As a result of immunohistochemical staining with VEGF-c from the primary tumor, no statistically significant difference was found between lymph node metastasis and apical lymph node metastasis. CONCLUSION: No difference was found between histochemical study and immunohistochemical staining in the evaluation of apical lymph nodes. This suggested that histochemical examination of apical lymph nodes was sufficient to reduce costs. No correlation was found between primary tumor VEGF-c levels and apical lymph node metastasis. Keywords: Apical lymph node, colorectal cancer, micrometastasis, VEGF-c