胃下部癌常规病理阴性No.9组淋巴结微转移研究  

STUDY ON MICROMETASTASIS IN NEGATIVE GROUP-9 LYMPH NODES BY CONVENTIONAL PATHOLOGY IN THE LOWER THIRD OF GASTRIC CANCER

作　　者：徐克锋[1] 周岩冰[1] 刘相萍[2] 李玉军[3] 从林[3] 李宇[1] 

机构地区：[1]青岛大学医学院附属医院普外科,山东青岛266003 [2]青岛大学医学院分子生物学教研室,山东青岛266003 [3]青岛大学医学院病理科,山东青岛266003

出　　处：《青岛大学医学院学报》2009年第5期462-464,共3页Acta Academiae Medicinae Qingdao Universitatis

摘　　要：目的检测胃下部癌常规病理阴性No.9组淋巴结微转移情况,并分析淋巴结微转移与临床病理因素的关系。方法分别应用淋巴结组织连续切片法和端粒重复序列扩增（TRAP）-酶联免疫吸附试验（ELISA）方法,检测41例胃下部癌病人No.9组82枚常规病理阴性的淋巴结（每例2枚）,结合临床病理资料进行统计分析。结果连续切片法检测发现3例病人4枚淋巴结发生微转移,对该4枚淋巴结行端粒酶活性检测,结果均呈阳性。对连续切片阴性者检测发现另有8例病人的13枚淋巴结发生微转移,两种检测方法的差异具有显著性（χ2=6.125,P〈0.05）。本组病人No.9组淋巴结微转移率为26.83%（11/41）,其淋巴结微转移度为20.73%（17/82）。淋巴结微转移与病人年龄、性别、分化程度差异无统计学意义（χ2=0.322~1.328,P〉0.05）,但与原发肿瘤大体分型、肿瘤直径、浸润深度及临床分期有关（χ2=5.455~8.389,P〈0.05）。结论胃下部癌病人No.9组淋巴结有较高的微转移率,建议对常规病理检查无淋巴结转移病人行微转移检测,以准确分期及指导治疗。Objective To investigate the lymph node micrometastasis of negative group-9 lymph nodes by conventional pathology in lower part gastric cancer and analyze its association with clinical pathology. Methods Serial sections and telomeric repeat amplication protocol （TRAP）-enzyme linked immunosorbent assay （ELISA） were applied to detect lymph node micrometastasis of 82 negative lymph nodes in 48 patients （two in each case） with lower-part gastric cancer, the data was analyzed statistically. Results Micrometastasis was found in four lymph nodes （3 cases） by serial sections and by TRAP-ELISA. For negative lymph nodes on conventional pathology, 13 lynph nodes （8 cases） were found positive by TRAP-ELISA, the difference between the two methods were significant （χ2= 6. 125, P=0. 05）. In the present study, the micrometastasis rate of group-9 lymph nodes was 26.83% （11/41） and the ratio of lymph node micrometastasis was 20.73% （17/82）. The differences among micrometastasis, patient＇s age,gender and histological differentiation were not statistically significant （χ2 = 0. 322-1. 328, P〉0. 05）, but were associated with gross typing and diameter of the tumor, depth of infiltration and TNM staging （χ2= 5. 455- 8. 389, P〈0. 05 ）. Conclusion Group-9 lymph nodes in lower-third gastric cancer have a relatively higher rate of micrometastasis. For a negative lymph-node findings, micrometastasis check is recommended for exact staging and therapy.

关 键 词：胃肿瘤 肿瘤转移 病理学 淋巴结 

分 类 号：R735.2[医药卫生—肿瘤]