胃癌阴性淋巴结微转移检测的临床意义

Clinical pathological value of immunohistochemical detection of micrometastases in 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,用广谱细胞角蛋白单克隆抗体(AE1/AE3)检测42例常规病理检查无淋巴结转移的307个淋巴结。结果:其中10例(23.8%)胃癌发现有31个(10%)淋巴结存在微转移。微转移与浸润深度有关,浸润程度越深,微转移发生率越高。弥漫型胃癌微转移发生率高于肠型胃癌(P<0.05)。结论:对常规检查淋巴结为阴性的胃癌,行淋巴结微转移检测,可能对精确的临床分期、指导治疗、判断预后有积极临床意义。

Objective： To study the relationship between lymph node micrometastasis and clinical pathological parameters. Methods： Immunohistochemical method was used to detect cytokeratin （AE1/AE3） in 307 lymph nodes from 42 cases of gastric cancer. The conventional pathological diagnosis had showed that there was no lymph node metastasis. Results： The evidence of mierometastasis was found in 31（10%） of 307 lymph nodes from 10（23. 8%） of 42 cases. The incidence of micrometastasis was correlated with the depth of cancer invasion. The incidence of lymph node micrometastasis was signifieantly higher in the diffuse type than that in the intestinal type of gastric cancer（P〈0. 05）. Conclusion： It is recommended micrometastasis detection to negative lymph node from the patients with gastric cancer, in order to determine precisely the tumor stage, guide clinical therapy and predict prognosis.