N_0期31例胃癌患者区域淋巴结组织中CK19的表达

Expression of CK19 in local lymph nodes of 31 patients with N_0-stage gastric carcinoma

目的:探讨常规染色显示无淋巴结转移的胃癌患者淋巴结微转移发生情况以及预后意义。方法:回顾性分析31例常规染色提示无淋巴结转移的胃癌患者(T1-3N0M0),将常规检查阴性的淋巴结用CK19单克隆抗体进行免疫组织化学染色。结果:31例常规病理检查无淋巴结转移的患者中位随访期为50个月,所切除淋巴结的中位数为8个,总的5年生存率为53.7%,其中通过免疫组化发现的微转移检出率为32.3%(10/31)。淋巴结微转移患者5年生存率为30%,低于无微转移患者的66.5%,P=0.036。结论:CK19的免疫组化染色是检测胃癌淋巴结微转移的敏感易行的方法,且微转移的检测有助于明确分期、判断预后及指导治疗。

OBJECTIVE:To investigate the prognostic significance of gastric cancer micrometastasis in regional lymph nodes. METHODS:Thirty-one patients with pathologic T_ 1-3 N_0M_0 gastric carcinoma who underwent gastric resection between Jan. 1,1995 and Mar.31,1997 were studied. The sections of the “negative” lymph nodes diagnosed by H&E staining were stained immunohistochemically by anti-CK19 monoclonal antibody. Associations between clinicopathological factors and LN micrometastasis as well as micrometastasis and survival were sought. RESULTS: Micrometastasis was found in 32.3%(10/31) of the patients. The occurrence was related with the depth of tumor invasion. The 5-year-survival of the patients with LN micrometastasis was lower than that of ones without micrometastasis. CONCLUSIONS: CK19 is a useful tumor-marker to detect micrometastasis in lymph nodes. It is also of value to predict prognosis, monitor therapeutic effects and offer suggestions for rational treatment.