Dukes B期结直肠癌淋巴结微转移对预后的影响  

Prognostic:significance of lymph node micrometastasis in Dukes B colorectal cancer

作　　者：季政一[1] 陈德建[1] 戴雪明[1] 裘正军[1] 

机构地区：[1]上海交通大学附属第一人民医院普外科,200080

出　　处：《上海医学》2006年第7期423-425,F0003,共4页Shanghai Medical Journal

摘　　要：目的探讨Dukes B期结直肠癌患者淋巴结微转移与临床病理学特征的关系及其对预后的影响。方法收集2000年1月至12月60例施行根治性切除术的Dukes B期结直肠癌患者的l临床资料,以及所有经常规苏木精-伊红(HE)染色为阴性的淋巴结石蜡包埋块,共获取系膜淋巴结1018枚,应用抗角蛋白(CK)20单抗经免疫组织化学法进行淋巴结微转移的检测。结果60例Dukes B期结直肠癌患者中有19例(31．7%)、42枚(4．1%)淋巴结显示有微转移,淋巴结微转移与其他临床病理特征均无关(P值均＞0．05),有、无淋巴结微转移患者的死亡率及肿瘤复发或淋巴结转移发生率的差异均无显著性(P值均＞0．05)。结论Dukes B期结直肠癌患者存在较高的淋巴结微转移率,但淋巴结微转移对预后无明显影响。Objective There have been many controversies concerned about the prognostic significance of lymph node micrometastasis. This study was disigned to investigate the correlation between lymph node micrometastasis and clinicopathologic characteristics in patients with Dukes B colorectal cancer, and to assess the impact of lymph node micrometastasis on prognosis of colorectal cancer. Methods 60 patients with Dukes B colorectal cancer underwent curative radical resection and all paraffin-embeded nodes stained with hematoxylin and eosin （H＆E）negative were colleted from Jan. to Dec. 2000, 1 018 mesentric lymph nodes used the monoclonal antibodies against cytokeratins20 （CK20） and immunohistochemical techniqques （IHC） for detecting presence of micrometastasis. Results Lymph node micrometastasis was identified in 42 lymph nodes （4.1%） from 19 patients （31.7%） in 60 patients with Dukes B colorectal cancer, Clinicopathlogic parameters and five-year survival rate were compared between patients with and without lymph node micrometastasis. There were no significant difference between them by multivariate analyses and Kaplan-Meier life-table method. Conclusion There is a higher rate of nodal micrometastasis in patients with Dukes B colorectal cancer, but lymph node micrometastasis is not significantly correlated with the prognosis.

关 键 词：结直肠肿瘤 淋巴结微转移 免疫组织化学法 预后 

分 类 号：R735.3[医药卫生—肿瘤]