D2-40标记食管鳞癌淋巴管浸润的检测及其临床病理意义*

摘要

目的：探讨D2-40标记食管鳞癌淋巴管浸润（LVI）的临床病理意义。方法：应用免疫组织化学S-P法检测107例食管鳞癌D2-40蛋白表达并观察淋巴管受肿瘤细胞浸润的情况，分析其与食管鳞癌临床病理因素之间的关系，观察患者总生存期。结果：食管鳞癌组织LVI阳性组淋巴结转移率70%，LVI阴性组淋巴结转移率21%，LVI阳性组转移率高于阴性组，多因素分析显示两组间差异有统计学意义（P<0.001）。LVI阳性组中位生存时间为26个月，LVI阴性组中位生存时间43个月，单因素分析显示两组间差异有统计学意义（P=0.014），多因素分析显示LVI不能成为食管鳞癌术后患者预后的独立危险因素（P=0.062），淋巴转移（P=0.031）、临床分期（P=0.019）和肿瘤残留（P=0.026）是预后的独立危险因素。结论：D2-40标记的LVI可以预测食管鳞癌患者的淋巴结转移。%Objective:This study aims to investigate the clinicopathological significance of lymphatic vessel invasion (LVI) la-beled by D2-40 monoclonal antibody in esophageal squamous cell carcinoma (ESCC). Methods:Immunohistochemical assay was used to detect the expression of D2-40 and LVI in 107 ESCC cases. Then, the correlation between the clinicopathological feature and the overall survival time in patients was analyzed. Results:The lymph node metastasis rates were 70%and 21%in the LVI-positive and LVI-negative groups, respectively. The nodal metastasis rate was higher in the LVI-positive group than in the LVI-negative group. Mul-tivariate regression analyses showed that LVI was related to nodal metastasis (P<0.001). The median survival times of the patients were 26 and 43 months in the LVI-positive and LVI-negative groups, respectively. Although the univariate regression analysis showed signifi-cant difference between the two groups (P=0.014), the multivariate regression analyses revealed that LVI was not an independent prog-nostic factor for overall survival in the ESCC patients (P=0.062). Lymphatic node metastasis (P=0.031), clinical stage (P=0.019), and residual tumor (P=0.026) were the independent prognostic factors. Conclusion: LVI labeled by D2-40 monoclonal antibody is a risk factor predictive of lymph node metastasis in ESCC patients.