【摘要】 目的　探讨胃癌侵犯血管、神经及其对胃癌侵袭、转移和预后的意义。方法　对 6 8例进展期胃癌标本次连续切片进行血管内膜下弹力纤维VB :HE组织化学染色以及S - 10 0、CD34免疫组化染色 ,进行镜下观察和单因素及多因素分析。结果　血管受侵 52例 ( 76 .4 % ) ,表现为 4种类型 ,即血管壁受侵、游离癌细胞侵入血管腔、部分栓塞和完全栓塞。神经受侵犯 2 2例( 32 .35% )。血管、神经侵犯与肿瘤大小、侵袭深度、淋巴结转移和肿瘤TNM分期显著相关。单因素预后分析表明 ,有血管、神经侵犯的胃癌患者较无血管、神经侵犯者 ,预后明显较差。但多因素分析表明 ,胃癌对血管、神经的侵犯不是影响预后的独立因素。结论　血管和神经间隙均是胃癌侵袭转移的重要途径 ,胃癌对血管、神经的侵犯在一定程度上反映了癌细胞的侵袭能力 ,了解胃癌对血管、神经的侵袭情况对判断干预有一定的参考价值。更多还原

【Abstract】 Objective To investigate the blood vessel and perineural space invasion in gastric carcinoma and its clinical significance. Methods Serial sections from 68 cases of advanced gastric carcinoma were stained using the histochemical of VB: HE to show the die elastic fibers beneath the intima of blood vessels, and immunohistochemically staining with the antibodies against CD34, S-lOO antigen. The sections were read in microscope and the result was analyzed by SPSS software. Results The blood vessel invasion was found in 52 (76. 4%) cases, which presented as 4-types: wall invasion, free cancer cells into cavity, partial embolism and complete embolism. Neural invasion was found in 22(32.35%) cases. The invasion to the blood vessels and perineural space has a significant positive correlation with tumor size, depth of invasion, lymph node metastasis, and tumor stages. Univariate analysis showed that gastric carcinoma patients with blood vessel and perineural space invasion had very unfavourable prognosis than those without such invasion. Multivariate analysis, however, demonstrated that blood vessel and perineural space invasion were not independent prognostic factors. Conclusions Blood vessels and perineural apace were the important pathways for gastric carcinoma dissemination, and the invading to blood vessel and perineural space could reflect, to some degree, the invasive ability of gastric carcinoma. The state of invasion could be consulted in judging prognosis.更多还原