Detection of Occult N2 Disease with Molecular Techniques

Lymph node involvement is the most important factor affecting the prognosis and treatment of patients with potentially resectable NSCLC. Radiographic imaging is inadequate to ascertain lymph node involvement. Currently, lymph nodes are assessed pathologically using conventional histologic techniques; however, lymph node micrometastases may be missed, leading to inaccurate staging and suboptimal treatment. Assessment of occult involvement using antibody expression improves the sensitivity of lymph node analysis, and more advanced techniques, using molecular biologic methods, may further improve lymph node staging. Optimizing outcomes of patients with lung cancer depends on accurate lymph node staging, and the development of the strategies that improve the assessment of lymph node micrometastases will be beneficial.