结直肠癌淋巴结微转移检测的临床意义  

Clinical significance of micrometastasis detection in conventional pathologic nonmetastasis lymphnodes of patients with colorectal cancer

作　　者：于游[1] 王灿[1] 彭力[2] 吴强[1] 韩继明[1] 李雅嘉[1] 

机构地区：[1]重庆市急救医疗中心普外科,400014 [2]重庆市急救医疗中心病理科,400014

出　　处：《重庆医学》2010年第5期547-548,550,共3页Chongqing medicine

基　　金：重庆市卫生局科研基金资助项目(06-2-011)

摘　　要：目的探讨结直肠癌淋巴结微转移与临床病理参数的关系及其临床意义。方法采用免疫组织化学方法,用细胞角蛋白CK20及CEA检测53例常规病理检查无淋巴结转移的结直肠癌周围淋巴结509枚。结果53例结直肠癌患者中21例有淋巴结微转移(39.6%)。微转移与浸润深度有关,深层组织的微转移阳性率高于浅层,差异有统计学意义(P<0.05),PT3、PT4患者阳性率明显高于PT1、PT2患者,差异有统计学意义(P<0.05)。低分化癌微转移阳性率明显高于高分化癌,差异有统计学意义(P<0.05)。结论对常规检查淋巴结为阴性的结直肠癌,微转移检测可能对准确地确定临床分期、指导治疗、判断预后有积极临床意义。Objective To study the relationship between lymphnode micrometastasis and clinicopathological parameters. Methods Immunohistochemical method was adopted to detect CK20 and CEA in 509 lymphnodes from 53 cases of colorectal cancer, in which,conventional pathological diagnosis showed no lymph node metastasis. Results Micrometastasis was found in 47 lymphnodes （9.2%） of 21 cases （39.6%）. The incidence of micrometastasis was correlated with the depth of invasion,and the incidence of micrometastasis in PT3 and PT4 patients was more than that in PT1 and PT2 patients（P〈0.05）. The incidence of micrometastasis was also higher in the poorly differentiated cancer than that in well differentiated cancer （P〈0.05）. The histologicstage of the 19 （35.85%） micrometastasis patients was upstaged by the group of micrometastatic lymph nodes from stage Ⅰ tostage Ⅱ in 4 cases, stage HI in 15 cases. Conclusion Micrometastasis detection in negative lymph nodes of colorectal cancer i.s recommended to precisely determine the tumor stage,in order to direct cancer therapy and predict prognosis.

关 键 词：结直肠肿瘤 淋巴结微转移 免疫组化 肿瘤分期 

分 类 号：R735.3[医药卫生—肿瘤] R73-37[医药卫生—临床医学]