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目的探讨胃癌淋巴结微转移与临床病理参数的关系及其临床意义。方法采用免疫组织化学方法,应用细胞角蛋白19(CK19)和肿瘤相关糖蛋白72-4(CA72-4)联合检测40例常规病理检查无淋巴结转移的胃癌(pN0)周围淋巴结442枚。结果40例胃癌患者中9例有淋巴结微转移(22.5%)。淋巴结微转移与肿瘤浸润深度有关,pT3患者微转移阳性率高于pT1和pT2患者(P<0.05)。胃癌患者有微转移的5年生存率(44.4%)明显低于无转移者(93.5%)。结论对常规病理检查淋巴结为阴性的胃癌,淋巴结微转移检测对准确地确定临床分期、指导治疗、判断预后有积极临床意义。
Objective To investigate the relationship between lymph node micrometastasis and clinicopathological parameters in gastric cancer and its clinical significance. Methods Immunohistochemical method was used to detect the expression of cytokeratin 19 (CK19) and tumor associated glycoprotein 72-4 (CA72-4) in 40 cases of peripheral lymph nodes in 40 cases of gastric cancer without lymph node metastasis (routine pathological examination). Results Nine of 40 gastric cancer patients had micrometastases (22.5%). Lymph node micrometastasis was related to the depth of tumor invasion. The positive rate of micrometastasis in pT3 patients was higher than that in pT1 and pT2 patients (P <0.05). The 5-year survival rate (44.4%) of micrometastases in patients with gastric cancer was significantly lower than those without metastasis (93.5%). Conclusion The routine pathological examination of lymph nodes negative for gastric cancer, lymph node micrometastasis detection to accurately determine the clinical stage, guiding treatment, prognosis has a positive clinical significance.