单克隆抗角蛋白8和18抗体免疫组化检测胆囊癌淋巴结微转移的临床意义  

Immunohistochemical detection of lymph node micrometastasis in gallbladder carcinoma with cytokeratins 8 and 18 antibody

作　　者：刘红山[1] 潘承恩[1] 苏国强[2] 王自法[1] 吕毅[1] 齐咏[2] 

机构地区：[1]西安交通大学第一医院肝胆外科,710061 [2]河南新乡医学院第一附属医院

出　　处：《中华普通外科杂志》2000年第10期587-589,共3页Chinese Journal of General Surgery

摘　　要：目的　探讨用单克隆抗体———抗角蛋白 8和 18抗体免疫组化检测胆囊癌患者淋巴结微转移的敏感性及其临床意义。方法　检测 5 2例胆囊癌根治术患者的 185个区域性淋巴结 ,每例患者的原发肿瘤和区域性淋巴结均用HE和抗角蛋白 8和 18抗体染色 ,计算Ⅱ期或进展期患者的生存率。结果　所有原发肿瘤抗角蛋白 8和 18抗体检测均为阳性 ,常规组织学检测 33个淋巴结阳性 ,用抗角蛋白 8和 18抗体染色也是阳性 ,但另外检测出 14个淋巴结有微转移。有微转移患者与没有微转移患者的生存率比较 ,差异有显著意义 (P <0 0 5 ,)。在常规组织学检测中无淋巴结转移者 ,用抗角蛋白 8和 18抗体检测微转移的患者 ,其预后较差 (P <0 0 1)。结论　用抗角蛋白 8和 18抗体免疫组化检测胆囊癌患者 ,有助于预测根治术后患者的生存率 ;胆囊癌患者中淋巴结微转移可能是淋巴播散的一个指标 ,对于指导术后治疗具有重要意义。Objective To explore the sensitivity and clinical significance of the immunohistochemical detection of lymph node micrometastasis in patients with gallbladder carcinoma(GBC). Methods 185 regional lymph nodes removed from 52 patiens with GBC undergoing a radical resection were examined. The primary tumor and the reginoal lymph nodes in each case were stained with both HE and cytokeratins 8 and 18 antibody. Survival rates were calculated in patiens with stage Ⅱ and upper malignancy. Results All GBCs were positive by cytokeratins 8 and 18 antibody staining. 33 lymph nodes were positive both on HE and cytokeratins 8 and 18 antibody. There were 14 HE negative lymph nodes that found positive (micrometastasis) by immunohistochemistry. Patiens with micrometastasis showed a significantly poor survival status than those without micrometastasis ( P <0 05). Conclusions The immunohistochemical detection of lymph node micrometastasis by antibody against cytokeratins 8 and 18 in GBC patiens undergoing radical resection is useful in predicting survival rate. Lymph node micrometastasis is an indicator of lymph node dissemination in GBC patiens.

关 键 词：胆囊肿瘤 淋巴结微转移 抗角蛋白 单克隆抗体 

分 类 号：R735.8[医药卫生—肿瘤]