食管癌淋巴结微转移的研究

Research of micrometastasis to histologically negative lymph node in esophageal cancer

目的探讨食管癌术后常规病理检查无转移性淋巴结微转移的发生率、类型及临床意义。方法选择食管癌术后≥3年的患者,常规病理检查淋巴结转移阴性患者68例,采用抗角蛋白抗体免疫组化染色查找癌细胞,免疫组化染色阳性癌细胞每个视野不超过5个就确定为微转移。结果16例患者22个淋巴结检出微转移1.8%(22/1246)存在微转移的患者术后复发率为50.0%(8/16),不存在微转移的复发率为11.5%(6/52),两者差异有统计学意义,P=0.008;存在微转移的患者术后生存率低于无微转移的患者,P<0.05。结论检测淋巴结微转移对于常规病理检查阴性患者的治疗及预后具有重要的临床意义。

OBJECTIVE: To explore the prevalence,patterns and clinical significance of nodal micrometastases in patients with esophageal cancer.METHODS: Lymph nodes systematically removed from 68 patients without conventional histologic evidence of lymph node metastasis from esophageal squamous cell carcinoma were immunohistochemically examined to detect cells that were stained for cytokeratins by certokertains of the monoclonal antibody cocktail AE1/AE3. Postoperative care and survival were compared in patients with and without such micrometastases. RESULTS: Nodal micrometastases were identified in 22 lymph nodes (1.8%,22/1 246) of 16 patients.Postoperative tumor recurrence was significantly more frequent in patients with micrometastases (50.0%,8/16) than in those without (11.5%,6/52), P=0.008.The relapse-free survival rate of patients with micrometastases was lower significantly than that of patients without micrometastases P< 0.05. CONCLUSION: Immunohistochemically detected nodal micrometastasis is significant in esophageal cancer with histologically negative nodes.