交感神经纤维减少对胃癌患者术后护理及临床预后的影响

Effect of sympathetic nerve fibers decrease on postoperative nursing and clinical prognosis for patients with gastric cancer

目的探讨胃癌患者中局部组织内交感神经纤维减少对癌症进展、术后护理及临床预后的影响。方法采用回顾性研究,临床获得120例胃癌患者的术中组织样本并进行酪氨酸羟化酶(TH)的免疫组织化学染色,显微镜下对组织内的交感神经纤维的分布进行评估,并与患者的病理学诊断、临床护理及相关预后进行关联分析。结果正常胃壁组织内的动脉完全被交感神经纤维覆盖,而胃癌组织内围绕动脉周围组织的TH免疫活性显著降低;交感神经纤维缺失程度与癌症细胞的侵袭深度(P<0.01)、淋巴结转移(P<0.01)及微血管密度(P=0.043)呈显著相关性;同时交感神经纤维缺失严重的患者显示出明显较高的临床护理要求和难度,且临床预后更差,多变量分析显示具有独立关联性。结论胃癌患者局部组织动脉周围交感神经纤维的缺失可能与微血管的生成及胃癌侵袭性增强相关,可作为潜在的临床标记物,提示患者的护理要求及相关临床预后。

Objective To investigate the effect of sympathetic nerve fibers decrease on cancer progression,the postoperative patient care and clinical prognosis of patients with gastric cancer. Methods A retrospective study was made,and 120 patients with gastric cancer were collected and the histopathological staining of tyrosine hydroxylase （TH） was performed. The distribution of sympathetic nerve fibers in the tissues was evaluated under microscope. The pathology diagnosis, clinical nursing and related prog- nosis were analyzed. Results The arteries in the normal gastric wall were completely covered by sympathetic nerve fibers, while the TH activity in the surrounding tissues of the gastric cancer tissue was significantly decreased. The decrease extent of the sym- pathetic nerve was significantly related with the invasion depth of the cancer cells （P〈0.01） ,lymph node metastasis （P〈0.01） and microvessel density （P = 0. 043）, while patients with more severe sympathetic nerve fibers decrease showed significantly higher clinical care requirements and difficulties, and the clinical prognosis was worse. Multivariate analysis showed independent association. Conclusion The loss of sympathetic nerve fibers in the local tissue of patients with gastric cancer may be related to the formation of microvessels and the increased invasion of gastric cancer. It can be used as potential clinical markers, which indi- cates the nursing requirements and related clinical prognosis.