摘要
目的 评价新辅助化疗治疗Ⅲ期胃癌淋巴结微转移疗效及树突状细胞(dendritic cells,DC)相关免疫学改变.方法 新辅助化疗56例和未行新辅助化疗20例共76例Ⅲ期胃癌患者术后常规病理检测阴性淋巴结,采用免疫组化方法检测CK-20的表达.对76例Ⅲ期胃癌患者的HE(+)淋巴结、HE(-)的近癌灶淋巴结、HE(-)的远癌灶淋巴结标本采用免疫组化方法检测DC的数量.结果 在新辅助化疗组2例患者存在微转移(2/56),未新辅助化疗组均检测出微转移(20/20),差异有统计学意义(x2=66.623,P=0.000).HE阳性淋巴结群:2次化疗组、3次化疗组、4次化疗组CD83阳性DC数量较未化疗组均有显著增多(P20 =0.001、P30=0.000、P40 =0.000);HE阴性的近癌灶淋巴结群:3次化疗组、4次化疗组CD83阳性DC的数量较未化疗组显著增多(P30=0.001、P40=0.001);HE阴性的远癌灶淋巴结群:4次化疗组CD83阳性DC的数量明显高于未化疗组、2次化疗组和3次化疗组,差异均有统计学意义(P40 =0.000、P42=0.000、P43=0.001).结论 新辅助化疗能有效控制Ⅲ期胃癌淋巴结微转移,并上调淋巴结中成熟DC的数量.
Objective To evaluate the effect of neoadjuvant chemotherapy on lymph node micrometastasis and DC cell number in stage Ⅲ gastric cancer patients.Methods Lymph node micrometastases in pathologically negative lymph nodes from 76 stage Ⅲ gastric cancer patients [56 cases with neoadjavant chemotherapy (NCT) and 20 cases without],were assessed by cytokeratin-20 antibody.Dendritic cells (DC) in HE positive lymph nodes,HE negatives near tumor foci and HE negatives far foci were assessed by CD83 antibody respectively.Patients were divided into four groups:group 0 (20 cases without NCT),group 2 (two courses of NCT in 29 patients),group 3 (three courses of NCT in 16 patients),group 4 (four courses of NCT in 11 patients).Results In NCT group there were two patients with micrometastases (2/56).All the patients were with micrometastases in control group (20/20).Difference was statistically significant (P =0.000).In HE-positive lymph node group:the number of CD83-positive DC in 2 times group,3 times group,and 4 times group when compared with no chemotherapy group were statistically significant (P20 =0.001,P30 =0.000,P40 =0.000).In HE-negative lymph node near foci group:the number of CD83-positive DC in 3 times group,and 4 times group compared with 0 group were statistically significant increased (P30 =0.001,P40 =0.001).In HE-negative lymph node far foci group:the number of 4 times group was significantly higher than 0,2 and 3 group (P40 =0.000,P42 =0.000,P43 =0.001).Conclusions Neoadjuvant chemotherapy is effective in the prevention of lymph node micrometastases in stage Ⅲ gastric carcinoma and it increases the number of mature dendritic cells in lymph nodes.
出处
《中华普通外科杂志》
CSCD
北大核心
2014年第2期85-88,共4页
Chinese Journal of General Surgery
关键词
胃肿瘤
肿瘤转移
化学疗法
辅助
树突细胞
Stomach neoplasm
Neoplasm metastasis
Chemotherapy,adjuvant
Dendritic cells