胃癌神经及脉管浸润的危险因素分析

Risk Factors of Perineural and Lymphvascular Invasion in Gastric Cancer

目的探讨胃癌神经浸润(perineural invasion,PNI)及脉管浸润(lymphvascular invasion,LVI)的危险因素,为临床防治工作提供可靠的理论依据。方法收集胃癌患者的手术病检石蜡标本及相应临床病理资料,应用苏木精-伊红(hematoxylin-eosin,HE)染色及免疫组化方法(immunohistochemistry,IHC)检测胃癌组织中S100、D2-40和CD34的表达情况,根据HE及IHC结果判断PNI及LVI;采用单因素/多因素方法分析胃癌PNI及LVI与临床病理因素之间的关系,探讨胃癌PNI及LVI浸润的危险因素。结果 91例胃癌患者中PNI及LVI的阳性率为44.5%;单因素分析显示,肿瘤分化程度、淋淋巴结转移个数和肿瘤浸润深度与PNI及LVI有关(P<0.05),患者的性别、年龄、肿瘤直径及幽门螺杆菌感染(Helicobacter pylori,Hp)均与PNI及LVI无关(P>0.05);多因素Logistic回归分析显示,肿瘤分化程度、淋巴结转移个数和肿瘤浸润深度与PNI及LVI呈正相关(P<0.05)。结论肿瘤分化程度、淋巴结转移个数、淋巴结转移个数和肿瘤浸润深度是影响胃癌PNI及LVSI的独立危险因素。

Objective To explore the risk factors of perineural invasion （PNI）and lymphvascular invasion（LVI） in gastric cancer which could provide reliable theoretical basis for clinical prevention and treatment work. Methods To explore the risk factors of PNI and LVI in gastric cancer, we collectted pathological paraffin specimens and the corresponding clinical data and detectted the expression of S100, D2-40 and CD34 in gastic cancer by hematoxylin-eosin （HE） and immunohistochemistry（IHC） staining.Then, according to the results of HE and IHC to comfirm PNI andLVI, we analyzed the relationship between PNI and LVI and clinicopathological factors by univariate/multivariate methods. Results The univariate analysis illustrated that tumor differentiation, lymph node metastasis and the depth of tumor invasion were associated with the PNI and LVI. The gender, age, the tumor size, Helicobacter pylori （Hp） infection were not associated with the PNI and LVI （P〉0.05）. The multivariate Logistic regression analysis showed that tumor differentiation, lymph node metastasis and the depth of tumor invasion were related to the PNI and LVI（P〈0.05）. Conclusion Tumor differentiation, lymph node metastasisand the depth of tumor invasion are independent risk factors for PNI and LVI in gastric cancer.