pN0胃癌淋巴结微转移的检测及其临床意义

Detection of micrometastasis in lymph nodes and its clinical significance in patients with pN0 gastric cancer

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,应用细胞角蛋白19(CK19)和肿瘤相关糖蛋白72-4(CA72-4)联合检测40例常规病理检查无淋巴结转移的胃癌(pN0)周围淋巴结442枚。结果40例胃癌患者中9例有淋巴结微转移(22.5%)。淋巴结微转移与肿瘤浸润深度有关,pT3患者微转移阳性率高于pT1和pT2患者(P<0.05)。胃癌患者有微转移的5年生存率(44.4%)明显低于无转移者(93.5%)。结论对常规病理检查淋巴结为阴性的胃癌,淋巴结微转移检测对准确地确定临床分期、指导治疗、判断预后有积极临床意义。

Objective To evaluate the relationship between lymph node micrometastasis and clinicopathological parameters and the clinilcal significance of lymph node micrometastasis in gastric cancer. Methods Immunohistochemical method was adopted to detect, with the antibodies of cytokeratin 19（CKI9） and carcinoembryonic antigen 72 -4 （CA72 -4 ） , in 442 lymph nodes from 40 cases of gastric cancer, in which conventional pathological diagnosis showed no lymph node metastasis. Results Lymph node micrometastasis was found in 9 of 40 patients（22.5% ）. The incidence of micrometastasis was correlated with the depth of invasion, and the incidence of micrometastasis in pT3 patients was more than in pTl and pT2 patients（ P 〈0.05）. The 5 -year survival rate was significantly lower for patients with lymph node micrometastasis（44.4% ） than for those without lymph node micrometastasis（93.5% ）. Conclusion Lymph node micrometastasis detection in conventional pathologically node - nega- tive gastric cancer is recommended to precisely determine the tumor stage, in order to direct cancer therapy and predict prognosis.