胃癌中肿瘤出芽判断淋巴结转移的价值

Value of tumor budding in the prediction of lymph node metastasis in gastric cancer

目的研究胃癌中肿瘤出芽判断淋巴结转移的价值。方法2004年1月至2008年12月有完整淋巴结病理学资料的胃癌D：／D，手术患者91例，全数淋巴结检查，参照Ueno等的研究判断肿瘤出芽。结果本组91例共切除淋巴结3475枚，平均每例取约（38．18±18．25）枚，91例胃癌中有72例出芽。肿瘤出芽与淋巴结转移的程度（PN分期）、肿瘤浸润深度呈显著性相关。肿瘤出芽对预测胃癌淋巴结转移的灵敏度，特异性，阳性预测值，阴性预测值，诊断准确度分别为95．38％，61．54％，86．11％，84．21％，85．71％。结论通过HE染色镜下检测胃癌中肿瘤有无出芽来判断有无局部淋巴结转移，有助于快速确定胃癌患者局部淋巴结转移的状况，对及时辅助治疗有帮助。

Objective To study the value of tumor budding in the prediction of lymph node metastasis in gastric cancer. Methods Clinical data of 91 patients with gastric cancer who underwent D2/D3 operation in our hospital from January 2004 to December 2008 and had complete pathologic records were retrospectively analyzed. Tumor budding was identified by the method as previously described by Ue- no and his colleagues. Resul~ In total,3475 lymph nodes were dissected from the 91 patients,and the average number was 38.18 -＋ 18.25 lymph nodes/per patient. Tumor budding were detected in 72 gastric cancer patients. Strong correlation was found between tumor budding and the ratio of lymph node metastasis （ PN stage）, and the tumor invasive depth. The sensitivity, specificity, positive prediction rate, negative pre- diction rate and accuracy of prediction of lymph node metastasis with tumor budding were 95. 38% , 61.54% ,86.11% ,84. 21% and 85.71% ,respectively. Conclusion Lymph node metastasis can be predicted by tumor budding. The stage of local lymph node metastasis can be rapidly evaluated by the status of tumor budding in gastric cancer.