Basic Aspect: Methodology
Initially, micrometastases in the regional lymph nodes (lymph node [LN] micrometastases; LNMs) were detected by immunohistochemical analysis of epithelial markers, and the prognostic significance of LNMs has been a major focus for many years. In addition,
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Lymph Node Metastasis in Gastrointestinal Cancer
Shoji Natsugoe Editor
Lymph Node Metastasis in Gastrointestinal Cancer
Editor Shoji Natsugoe Department of Digestive Surgery, Breast and Thyroid Surgery Kagoshima Japan
ISBN 978-981-10-4698-8 ISBN 978-981-10-4699-5 (eBook) https://doi.org/10.1007/978-981-10-4699-5 Library of Congress Control Number: 2018965728 © Springer Nature Singapore Pte Ltd. 2019 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors, and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. This Springer imprint is published by the registered company Springer Nature Singapore Pte Ltd. The registered company address is: 152 Beach Road, #21-01/04 Gateway East, Singapore 189721, Singapore
Preface
There is a famous sentence: “The doctor who controls metastasis controls cancer”. One of the characteristics of a malignant tumor is the ability to metastasize. If a tumor has high malignant potential, metastasis is often seen in wide areas. Thus, lymph node metastasis is one of the most important prognostic factors in various carcinomas, including gastrointestinal (GI) cancer. There are several biological and morphological pathways by which lymph node metastasis can arise: invasion into a deeper layer, detachment of tumor cells from the primary tumor, infiltration into intramural lymphatics, flow to extramural lymphatics, arrival to afferent lymphatics of a marginal sinus, movement to the lymph node cortex, and implantation of tumor cells into the node and formation of metastasis. When surgeons and oncologists treat cancer patients, it is necessary to have sufficient understanding of both the basic and clinical aspects of nodal metastasis. In the basic aspect, knowledge of the anatomy and physiology of lymphatics and lymph nodes is essential when performing surgical treatment. The molecular mechanism in lymph node metastasis and immunology for lymph nodes is also important when doing chemo and/or
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