胃癌阴性淋巴结的微转移检测的临床意义  

Clinical significance of micrometastasis detection in conventional pathologic nonmetastasis lymph nodes of patients with gastric cancer

作　　者：史良会[1] 赵国海[1] 黄文斌[2] 

机构地区：[1]皖南医学院附属弋矶山医院外科,安徽芜湖241001 [2]皖南医学院病理学教研室,安徽芜湖241001

出　　处：《中国普通外科杂志》2002年第4期208-211,共4页China Journal of General Surgery

摘　　要：目的　探讨胃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CK19,细胞角蛋白CK 2 0及CD 44v6检测 5 3例常规病理检查无淋巴结转移的胃癌周围淋巴结 5 0 9枚。结果　 5 3例胃癌患者中 2 1例有淋巴结微转移 (3 9.6% )。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 (P <0 .0 5 ) ,PT3,PT4 患者阳性率明显高于PT1 ,PT2 患者。低分化癌微转移阳性率明显高于高分化癌 (P <0 .0 5 )。结论　对常规检查淋巴结为阴性的胃癌 ,微转移检测可能对准确地确定临床分期、指导治疗。Objective To study the relationship between lymph node micrometastasis and clinicopathological parameters. Methods Immunohistochemical method was adopted to detect CK19,CK20 and CD44v6 in 509 lymph nodes from 53 cases of gastric cancer, in which, conventional pathological diagnosis showed no lymph node metastasis. Results Micrometastasis was found in 47 lymph nodes (9.2%) of 21cases ( 39.6 %). The incidence of micrometastasis was correlated with the depth of invasion, and the incidence of micrometastasis in PT 3 and PT 4 patients was more than that in PT 1 and PT 2 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 histologic stage of the 19 (35.85%) micrometastasis patients was upstaged by the group of micrometastatic lymph nodes from stage Ⅰ to stage Ⅱ in 4 cases, stage Ⅲ in 15 cases. Conclusions Micrometastasis detection in negative lymph nodes of gastric cancer is recommended to precisely determine the tumor stage,in order to direct cancer therapy and predict prognosis.

关 键 词：胃癌 阴性淋巴结 微转移 检测 病理学 肿瘤浸润力 

分 类 号：R735.2[医药卫生—肿瘤]