【摘要】 目的分析淋巴结微转移在贲门癌病理分期上的临床意义。方法收集2005年1月至2009年12月间海南省农垦总医院行根治性手术的48例PT1-4N0贲门癌患者临床资料,共获取常规病理学检查阴性的淋巴结323枚。采用免疫组织化学方法,用细胞角蛋白19(CK19)单抗和CD44v6单抗对淋巴结进行检测,并结合临床病理资料进行统计学分析。结果共9例(18.75%)14枚淋巴结(4.33%)发现微转移。有9例分期得到提高,重新分期率为18.75%。其中ⅠA→ⅠB期1例,ⅠB→ⅡA期3例,ⅡA→ⅡB期3例,ⅡA→ⅢA期1例,ⅡB→ⅢB期1例。微转移组的临床复发率明显高于无微转移组(66.67%vs 27.78%,χ2=4.752,P=0.029),5年生存率差异有统计学意义(16.67%vs64.71%,P=0.001)。结论免疫组织化学方法可以提高贲门癌患者淋巴结转移的检出率,有助于更准确地进行临床病理分期。更多还原

【Abstract】 Objective To evaluate the significance of lymph node micrometastasis in determining the stage of gastric cardia adenocarcinoma(GCA). Methods Three hundred and twentythree lymph nodes from 48 GCA patients with negative lymph node by routine pathological examination were examined immunohistochemically(IHC) for the lymph nodes micrometastasis using anti-CK19 and anti-CD44v6 monoclonal anti-body. Clinical data were analyzed by statistical methods. Results Micrometastasis was found in 14 lymph nodes(4.33%) from 9 cases(18.75%). Nine of those patients were up-staged(from stage Ⅰ A to Ⅰ B in one patient, stage Ⅰ B to Ⅱ A in three patients, stage Ⅱ A to Ⅱ B in three patients, stage Ⅱ A to Ⅲ A in one patient, stage Ⅱ B to Ⅲ B in one patient). The rate of restaging was 18.75%. Conclusion IHC assay can increase the detection rate of lymph node metastasis and has a significant impact on the staging of GCA.更多还原