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目的 探讨用单克隆抗体———抗角蛋白 8和 18抗体免疫组化检测胆囊癌患者淋巴结微转移的敏感性及其临床意义。方法 检测 5 2例胆囊癌根治术患者的 185个区域性淋巴结 ,每例患者的原发肿瘤和区域性淋巴结均用HE和抗角蛋白 8和 18抗体染色 ,计算Ⅱ期或进展期患者的生存率。结果 所有原发肿瘤抗角蛋白 8和 18抗体检测均为阳性 ,常规组织学检测 33个淋巴结阳性 ,用抗角蛋白 8和 18抗体染色也是阳性 ,但另外检测出 14个淋巴结有微转移。有微转移患者与没有微转移患者的生存率比较 ,差异有显著意义 (P <0 0 5 ,)。在常规组织学检测中无淋巴结转移者 ,用抗角蛋白 8和 18抗体检测微转移的患者 ,其预后较差 (P <0 0 1)。结论 用抗角蛋白 8和 18抗体免疫组化检测胆囊癌患者 ,有助于预测根治术后患者的生存率 ;胆囊癌患者中淋巴结微转移可能是淋巴播散的一个指标 ,对于指导术后治疗具有重要意义。
Objective To investigate the sensitivity and clinical significance of using monoclonal antibodies anti-keratin 8 and 18 antibody immunohistochemistry to detect lymph node micrometastasis in gallbladder cancer patients. METHODS: A total of 185 regional lymph nodes were examined in 52 patients undergoing radical gallbladder carcinoma. The primary tumors and regional lymph nodes in each patient were stained with HE and anti-keratin 8 and 18 antibodies to calculate the survival of patients with stage II or advanced disease. rate. Results All primary tumors were positive for detection of anti-keratin 8 and 18 antibodies. Conventional histological examination of 33 lymph nodes was positive and staining with anti-keratin 8 and 18 antibodies was positive, but 14 lymph nodes were also detected for micrometastases. The difference in survival between patients with micrometastases and those without micrometastases was significant (P < 0.05). In patients without lymph node metastasis in routine histological examination, patients with micrometastases detected with anti-keratin 8 and 18 antibodies had poorer prognosis (P < 0.01). Conclusion Immunohistochemical detection of gallbladder cancer patients with anti-keratin 8 and 18 antibodies is helpful to predict the survival rate of patients after radical resection; micrometastasis of lymph nodes in gallbladder cancer patients may be an indicator of lymphatic dissemination, which is a guide for postoperative treatment It is of great significance.