胃癌淋巴结微转移的临床研究

Clinical Study on Lymph Node Micrometastasis of Gastric carcinoma

目的 研究胃癌淋巴结微转移的情况及意义。方法 应用免疫组化方法 ,细胞角蛋白CK检测阴性淋巴结。结果 4 6例胃癌患者周围阴性淋巴结 6 2 4枚 ,4例患者 8枚淋巴结发现CK阳性细胞。弥漫型胃癌微转移率 (5 0 % )明显高于肠型胃癌 (4 76 % ) ,2者差异有显著性 (P <0 0 5 )。淋巴结微转移与肿瘤分期、浸润深度、部位、淋巴结转移、肿瘤大小及预后无关。结论 (1)胃癌周围阴性淋巴结存在微转移灶 ,为准确的临床分期和制定辅助治疗方案提供可能 ;(2 )微转移与预后无明显关系。

Objective To investigate the lymph node micrometastasis of gastric carcinoma and its clinical significance. Methods Immunohistochemical examination, cytokeratin CK test and routine pathologic exam were performed on the visibly normal lymph node around the stomach. Results Among the 624 lymph nodes, which had been drawn from the lymphatic tissue around the 46 stomachs of patients with gastric carcinoma, CK positive cells were found in 8 lymph nodes from 4 patients. The rate of micrometastasis of wide spread gastric carcinoma (50%) was much higher than that of gastric carcinoma of colon type (4.76%) and the difference between them was significant (P<0.05). However, we didn't find any evidence that could relate lymph node micrometastasis with the carcinoma's stating, infiltration levels, location, size, lymph node metastasis and the patients' prognosis. Conclusion The focal lesions of micrometastasis did exist in the visibly normal lymph node around the gastric carcinoma and the examination of micrometastasis could make accurate clinical staging and assist treatment programs of gastric carcinoma possible. Nevertheless, there was no clear relationship between micrometastasis and the patients' prognosis.