免疫组化检测胃癌淋巴结微转移的临床意义

Significance of micrometastasis detection in conventional pathologic non-metastasis lymph nodes in patients with gastric cancer

目的 探讨胃癌淋巴结微转移与临床病理参数关系及临床意义。方法 采用免疫组织化学方法,选用细胞角蛋白CK19、细胞角蛋白CK20及CD44v6检测43例常规病理检查未发现的胃癌周围转移淋巴结453枚。结果 43例胃癌患者中16例有淋巴结微转移(37.2％)。微转移与浸润深度有关(P<0.05),且PT3、PT4患者微转移阳性率明显高于PT1、PT2患者。低分化程度癌微转移阳性率明显高于高分化程度癌(P<0.05)。微转移检测使28.1％的胃癌重新分期。结论 对常规检查淋巴结为阴性胃癌的微转移检测有助于临床准确分期、指导临床治疗及对预后的估计。

Objective To study the significance of relationship between lymph node micrometastasis and clinic pathological parameters. Methods Using immunohistochemical method to detect CK19,CK20 and CD44v6 was made in 453 lymph nodes from 43 cases of gastric cancer,in whom,conventional pathological diagnosis showed no lymph node metastasis. Results Micrometastases were found in 37 lymph nodes (8. 2%) of 16 cases (37.2% ). The incidence of micrometastasis was correlated positively with depth of invasion; and the incidence of micrometastases of PT3 and PT4 was more than those of PT1 and PT2 patients(P<0. 05). The incidence of micrometastasis was also higher in the poor differentiated cancer than that in well differentiated one (P<0.05). The histologic stage of 12 (28.1%) cases was upstaged by the group of micrometastatic lymph nodes from stage Ⅰ to stage Ⅱ in 3 cases, stage Ⅲ in 9 cases. Conclusion Micrometastasis detection in negative lymph nodes of gastric cancer is recommended to precisely determine tumor stage, to indicate cancer therapy and to predict prognosis.