| 刘春晓 王海磊 冯美燕 王国富 薛英威 王宽.检测pT1-4aN1-3M0期胃癌淋巴结微转移检测的临床意义[J].,2015,15(31):6053-6056 |
| 检测pT1-4aN1-3M0期胃癌淋巴结微转移检测的临床意义 |
| Clinical Significance of Lymph Node Micrometastasis on Patients withpT1-4aN1-3M0 in Gastric Cancer |
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| DOI： |
| 中文关键词: 胃癌 淋巴结微转移 免疫组化 细胞角蛋-19 临床病理因素 |
| 英文关键词: Gastric cancer Lymph node micrometastasis Immunohistochemistry Cytokeration-19 Pathologic parameter |
| 基金项目:国家自然科学基金青年基金项目（81302058） |
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| 中文摘要: |
| 目的：探讨胃癌淋巴结微转移及临床病理因素对pT1-4aN1-3M0期胃癌患者术后5 年无瘤生存率的影响。方法：选取我院2009
年1 月至12 月期间胃肠外科单一手术组行D2 胃癌根治术pT1-4aN1-3M0期患者63 例1427 枚HE 染色阴性淋巴结，应用免疫组化
法检测这些淋巴结中CK19 表达，观察微转移的情况并分析发生微转移的胃癌患者临床病理特征及对患者5 年无瘤生存率的影
响。结果：临床病理分期pT1-4aN1-3M0胃癌患者中，经免疫组化染色，1427 枚HE常规染色阴性淋巴结中CK19 阳性表达率为15.49
%（221/1427）；63 例胃癌患者中CK19 表达阳性率39.68 %（25/63）；术后随访时间5.6～68.5 月（平均时间43.88 月），淋巴结中
CK19 阴性表达、阳性表达患者的总5 年生存率分别为52.63 %、28.00 %；两者无瘤生存率差异有统计学意义（x2=8.677，P=0.
003）。淋巴结CK19 阳性表达与胃癌患者的肿瘤直径（P＜0.05）、浸润胃壁深度（P＜0.05）有关。COX生存回归分析显示淋巴结微
转移为独立预后因素。25 例患者发现淋巴结微转移并推荐再分期，再分期率39.68 %（25/63）。结论：pT1-4aN1-3M0期胃癌病人，
CK-19 免疫组化法染色能检出常规HE 染色阴性淋巴结中的微转移，有助于细化分期、判断预后及指导治疗。 |
| 英文摘要: |
| Objective:To detect the effects of lymph node micrometastasis and clinicopathologic characteristics on 5-years of disease
free survival rate of patients with pT1-4aN1-3M0 in gastric cancer.Methods:Sixty-three patients of gastric carcinoma with pT1-4aN1-3M0
stage who underwent gastrectomy with lymphhadenetomy from January 2009 to December 2009 were enrolled, and 1427 lymph nodes
were harvested in all specimens. All the lymph nodes were negative by HE staining, and were tested by immunohistochemistry again for
CK19 expression. The lymph node micrometastasis or not was observed, and the relationships between CK19 positive and clinicopathologic
characteristics on 5-years of disease free survival rate of patientswith pT1-4aN1-3M0 in gastric cancerwas analyzed.Results:The positive
expression rate of CK19 was 15.49%in these negative lymph nodes (221/1427) and 39.68%in the 63 cases of patients by immunohistochemistry.
The detection of 5-years of disease free survival were 52.63 % and 28.00 % in negative and positive CK19 expression in follow
up of 5.6-68.5(average:43.88) months, and the difference had statistical significance(x2=8.677, P=0.003). Multivariate analysis identified
tumor diameter and depth of tumor invasion were related with CK-19 positive expression. Cox survival regression analysis indicated
that lymph node micrometastasis was independent clinicopathologic characteristics in patients with pTxN1-3M0 of gastric cancer. Twenty-
five patients were detected lymph node micrometastasis and recommend restage, the rate of restage was 39.68 %(25/63).Conclusion:Immunohistochemistry can detect lymph node micrometastasis who express negative by Hematoxylin-eosin staining in stage
pT1-4aN1-3M0 gastric cancer, which will contribute to correct staging and judge prognosis of this disease. |
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