D2—40／CKpan免疫组织化学双标记染色检测胃癌淋巴管癌栓及其临床意义  

Evaluation of lymphatic emboli in gastric cancer by D2-40/CKpan dual immunostain and its siotmificance

作　　者：张宝燕[1] 袁静[2] 李向红[2] 吕有勇 

机构地区：[1]中国人民解放军第一一七医院病理科,杭州310013 [2]中国人民解放军总医院病理科 [3]北京市肿瘤防治研究所病理科

出　　处：《中华胃肠外科杂志》2014年第2期145-149,共5页Chinese Journal of Gastrointestinal Surgery

基　　金：国家“863”计划项目（2006AA02A402）

摘　　要：目的对比应用D2．40／CKpan免疫组织化学双标记染色（双标记）和苏木精一伊红染色检测胃癌淋巴管癌栓及其预后的临床意义。方法收集2001年1—12月间于解放军总医院病理科行胃癌根治术的108例进展期胃癌的组织蜡块，以苏木精．伊红染色为对照．评估D2．40／CKpan双标记对淋巴管癌栓的检出情况，并分析其与淋巴结转移及患者总体生存的关系。结果苏木精．伊红染色检出淋巴管癌栓57例（52．8％），D2—40／CKpan双标记检出淋巴管癌栓73例（67．6％），后者检出率明显高于前者（P=0．007）；苏木精．伊红染色中8例为假阳性，24例为假阴性。经苏木精-伊红染色评估的淋巴管癌栓不仅与淋巴结转移有关（P=0．024），还与患者的总体生存有关（P=0．043）；但经D2．40／CKpan双标记评估的淋巴管癌栓则与淋巴结转移及预后均无关（辟0．422和P=-0．402）。结论D2．40／CKpan双标记提高了淋巴管癌栓的检出率，但基于其评估的淋巴管癌栓与患者淋巴结转移及预后均无关。Objective To investigate the evaluation of lymphatic emboli by D2-40/CKpan dual immunostain and its prognostic significance in advanced primary gastric adenocareinoma. Methods Tissue samples of 108 eases of advanced gastric adenocarcinoma with radical gastrectomy were collected from Chinese PLA General Hospital in 2001. Lymphatic emboli were evaluated by D2-40/CKpan dual immunostain on consecutive sections, and compared with routine HE staining. The correlation of lymphatic emboli with lymph node metastasis and overall survival was analyzed by Pearson Chi-squared test and univariate survival analysis, respectively. Results Lymphatic emboli were detected in 73/108 （67.6%） cases by D2-40/CKpan staining, compared to 57/108 （52.8%） by HE staining. There was significant difference （P=0.007）. Lymphatic emboli on HE staining revealed false negative in 24/108 cases and false positive in 8/108 cases. A significant correlation was found between lymphatic emboli and lymph node metastasis on HE staining（P=0.024）, while it was not found on D2-40/CKpan staining（P=-0.422）. The overall survival rate was significantly different between lymphatic emboli positive and negative cases on HE staining （P=0.043）. The overall survival rate was lower in lymphatic emboli positive cases on HE staining. Lymphatic emboli evaluated on D2-40/CKpan staining had no prognostic value （P=0.402）. Conclusion D2-40/CKpan dual immunostaining is more sensitive for lymphatic emboli in gastric adenocarcinoma but may not predict lymph node metastasis and survival, while HE staining may.

关 键 词：胃肿瘤 淋巴管癌栓 免疫组织化学 D2-40 CKpan 淋巴结转移 预后 

分 类 号：R735.2[医药卫生—肿瘤]