贲门癌淋巴结微转移的检测及意义

摘要

Objective To investigate the micrometastasis characteristics for gastric cardia adenocarcinoma( GCA) patients with negative lymph node by routine pathological examination and evaluate relationship between micrometastasis and clinicopathological features. Methods 323 lymph nodes from 48 GCA patients with negative lymph node by routine pathological examination were examined immunohistochemically for the lymph nodes micrometastasis with anti-CK19 and anti-CD44v6 monoclonal anti-body. Clinicopathological data were analyzed by statistical method. Results Micrometastasis was found in 14 lymph nodes(4. 33%) from 9 cases(18. 75% ). The micrometastasis in lymph node was correlated with the Lauren classification(P<0.05), but not correlated with age, sex, tumor size, depth of invasion and differentiation(P > 0.05). In 45 patients followed up, The 3-,5-year survival rates were significantly lower in micrometastasis group than in non-micrometastasis( P <0.01). Conclusions Micrometas tasis is common in lymph node in CCA patients without pathological report of lymphnode metastasis. Detecting of micrometastasis in lymph node is helpful for prognosis judgement of GCA patients.%目的 观察常规病理学检查无淋巴结转移的贲门癌淋巴结的微转移情况,并探讨其临床意义.方法 采用免疫组化SP法,用细胞角蛋白19 (CK19)单抗和CD44 v6单抗检测48例贲门癌患者常规病理学检查阴性的323枚淋巴结的微转移情况.结果 本组9例14枚淋巴结发现微转移.淋巴结微转移与贲门癌患者年龄、性别及肿瘤直径、浸润深度、分化程度无关(P均＞0.05),与贲门癌的Lauren分型有关(P＜0.05).45例随访患者中,有淋巴结微转移者3、5年生存率明显低于无淋巴结微转移者(P均＜0.01).结论 常规病理学检查无淋巴结转移的贲门癌患者淋巴结常存在微转移；淋巴结微转移的检测有助于贲门癌患者的预后判断.