胃癌神经旁浸润的临床意义

Clinical Significance of Perineural Invasion in Patients with Gastric Carcinoma

目的 :探讨胃癌神经旁浸润 (perineural invasion,PNI)的临床意义。方法 :对 132例行胃癌根治术病例的胃癌组织的石蜡标本行苏木素 -伊红 (HE)染色。当肿瘤细胞浸润神经束或神经束膜时 ,判断为 PNI阳性 ,并进一步分析PNI与胃癌临床病理特征的关系。结果 :PNI在 5 1.5 %的病例中呈阳性。PNI与 L auren分类 (P<0 .0 1)、肿瘤大小 (P<0 .0 1)、浸润深度 (P<0 .0 0 1)、淋巴结转移 (P<0 .0 0 1)、淋巴管浸润 (P<0 .0 0 1)和 TNM分期 (P<0 .0 0 1)密切相关。但PNI与患者年龄、性别、肿瘤位置和血管浸润均无关。结论 :胃癌神经旁浸润与肿瘤的进展密切相关 ,其可能有助于判断胃癌患者的预后 。

Objective:To investigate the clinical significance of perineural invasion in patients with gastric carcinoma.Methods:Paraffin sections of gastric carcinoma tissues obtained from 132 patients who underwent curative gastrectomy were stained with hematoxylin and eosin. PNI was assessed as positive when cancer cells were seen in the perineurium or neural fascicles. The relationship between PNI and clinicopathologic features of gastric carcinoma was studied.Results:PNI was positive in 51.5% of patients. PNI was closely related to Lauren classification (P<0.01), tumor size (P<0.01), depth of invasion (P<0.001), lymph node metastasis (P<0.001), lymphatic invasion (P<0.001), and TNM stage (P<0.001). However, PNI showed no correlation to age at surgery, gender, tumor location, and vascular invasion.Conclusions:PNI was closely related to the progression of gastric carcinoma, and it might be useful in determining the prognosis ,and should be described in routine pathology reports.