The single-variable regression analysis for the number of lymph nodes showed the following: OR 0.9, 95% CI 0.9�C1.0, p = 0.132. Analysis of the first lymph node level identified micrometastases in 3 (3%) patients (2 cases and 1 control) and isolated tumor cells in 39 (37%) patients (13 cases and 26 controls) (Table 2). One micrometastasis found in an immunohistochemically stained section was also present on the original Hematoxylin and eosin (HE) stained slide but was not recognized by the pathologist. Macrometastases in 3 (3%) patients (2 cases and 1 control) that had not been recognized as lymph node metastases on the original HE stained Ataluren
slides were also seen. They had been described as vascular invasion or tumor deposits without lymphoid tissue in the pathology reports. On the immunohistochemically stained slides of all levels, lymphoid tissue was present around Lapatinib
the tumor cells. These macrometastases were excluded from further analysis. All macrometastases and micrometastases were detected by both conventional and automated microscopy. Automated microscopy led to the detection of additional isolated tumor cells (McNemar's test, 39 vs. 10 patients, respectively, p < 0.001) (Table 3). All but 1 isolated tumor cell found by conventional microscopy was also detected by automated microscopy. The missed isolated tumor cell was overlooked during visual inspection of ARIOL system results by the operator. Analysis of a second level, resulted in additional detection of 1 patient with macrometastasis (a case), 1 patient with micrometastases (a case) and 9 patients with isolated tumor cells (2 cases and 7 controls) (Table 2). These patients had no tumor cells detected in the first level or in the original HE-stained slide. When analyzing a third level, 11 patients (3 cases and 8 controls) were additionally identified with isolated tumor cells and assessment of a 4th level, identified 2 patients (2 controls) with isolated tumor cells. This led to a total number of 61 patients with isolated tumor cells (Table 2). No additional macrometastases selleck products
or micrometastases were found when analyzing the 3rd and 4th level. In Figure 1, examples of micrometastases (Figs. 1a and 1b) and isolated tumor cells (Figs. 1c�C1f) are shown. Concluding, after analysis of 2 lymph node levels, macrometastases were observed in 1 patient (1 case) and micrometastases in 4 patients (3 cases and 1 control). Analysis of 2 additional lymph node levels solely identified the presence of isolated tumor cells. More patients with micrometastases were seen in the case group than in the control group (Fisher's exact test, 3 of 34 (9%) vs. 1 of 71 (1%), p = 0.099). There was no difference in the presence of lymph nodes harboring isolated tumor cells, between the case and control group (Chi-square test, 18 of 34 (53%) vs. 43 of 71 (61%), p = 0.459) (Table 4).