早期胃癌中淋巴结微转移及LMO4、DLEC1表达的临床意义

Clinical Significance of Lymph Node Micrometastasis of Early Gastric Cancer and Expression of LMO4 and DLEC1

目的探求早期胃癌中淋巴结微转移及LMO4、DLEC1表达的临床意义。方法纳入研究对象为早期胃癌患者共50例,均行胃癌根治术。术后平均随访35.2个月(28~60个月),每位患者平均淋巴结24.5枚不等,将所有淋巴结用HE和CK进行免疫组化染色。对淋巴结微转移情况及LMO4、DLEC1的表达进行统计分析。结果淋巴结微转移明显高于常规淋巴结转移率,组织学类型和浸润胃壁深度与淋巴结微转移有正相关性,而其他临床病理因素与淋巴结微转移无明显相关性。LMO4表达与浸润深度、淋巴结微转移、组织分化程度、肿瘤大小呈明显正相关,DLEC1表达与浸润深度、淋巴结微转移、组织分化程度、肿瘤大小呈明显负相关。LMO4与DLEC1表达存在负相关。淋巴结微转移与无淋巴结微转移的患者5年无瘤生存率无显著差别。结论对于早期胃癌,若淋巴结中检测出微转移,其预后较差,术后复发率较高,术后应予以积极的辅助治疗。

Objective To study the clinical significance of lymph node micrometastasis of early gastric cancer and ex -pression of LMO4 and DLEC1.Methods 50 early gastric cancer patients received radical gastrectomy were selected. The average postoperative follow-up time was 35.2 months (28~60 months).The average lymph nodes was 24.5.All lymph nodes were de-tected by HE and CK immunohistochemistry. The lymph node micrometastasis and and expression of LMO 4 and DLEC1 were ana-lyzed.Results Lymph node micrometastasis was clearly higher than the general rate of lymph node metastasis, histological type and depth of invasion were positively correlated with lymph node micrometastasis, and other clinicopathological factors had no clear correlation with lymph node micrometastasis. The expression of LMO4 was positively correlated with invasion depth, lymph node micrometastasis,differentiation degree and tumor size. The expression of DLEC1 was negatively correlated with invasion depth,lymph node micrometastasis, differentiation degree and tumor size. There was a negative correlation between the expression of LMO4 and? DLEC1.There was no significant difference in 5-year disease-free survival rates between patients with and without lymph node micrometastasis. Conclusion Early gastric cancer with lymph node micrometastasis has bad prognosis and high re -currence rate, adjuvant therapy should be applied after surgery.