早期胃癌淋巴结微转移的临床病理

Clinicopathological study of lymph node micrometastasis in patients with early gastric cancer

目的研究早期胃癌淋巴结微转移与肿瘤临床病理的关系,并探讨合理的手术方案。方法对50例早期胃癌患者手术切除的1004枚淋巴结再次切片,然后进行HE染色和用抗细胞角质的单克隆抗体CAM5.2进行免疫组化染色,并分析微转移与临床病理因素和早期胃癌预后之间的关系。结果34例弥漫型早期胃癌中有11例(32.35%)存在微转移,而16例肠型早期胃癌中仅有1例(6.25%)存在微转移。微转移与原发肿瘤的组织学分类有关,弥漫型癌较早期胃癌更易发生微转移(P<0.05)。结论应用抗细胞角质的单克隆抗体CAM5.2进行免疫组化染色,对检测早期胃癌区域性淋巴结微转移具有较高的敏感性。淋巴结微转移对早期胃癌患者的预后有一定的负面影响。

Objective To study the relationship between lymph node micrometastasis in early gastric cancer and clinicopathology of tumor, and explore an appropriate operative procedure, Methods A total of 1 004 lymph nodes from 50 patients with early gastric cancer（EGC） were sliced and restained with H, E and immunohistochemical technique, respectively. Immunohistochemical staining was performed by the streptavidin-biotin immunoperoxidase method with cytokeratin-specific monoclonal antibody CAM5.2. The relationship between lymph node micrometastasis and clinicopathological characteristics of primary tumors and prognosis of EGC was analysed. Results The incidence of nodal micro-involvement was significantly increased in diffuse type cancerous lesions （n = 11 , 32.35% ） as compared with intestinal type cancerous lesions （ n = 1, 6.25% ） （P 〈 0.05） . Conclusion Immunohistochemical staining with cytokeratin-specific monoclonal antibody CAM 5.2 has been proved to be a very sensitive method for detecting cancerous micrometastasis in lymph node. Micrometastasis of lymph node has negative impacts on prognosis of EGC.