摘要
目的:探讨食管癌癌周淋巴结转移不同检测方法的临床意义。方法:采用流式细胞术对64例食管癌癌周淋巴结转移进行了检测,并和组织病理学检测结果进行了比较,还对不同方法检测的临床意义进行了分析。结果:采用FCM法检测癌周淋巴结转移(+)检出率显著高于组织病理学检测法,分别为87.5%和57.8%(P<0.05),食管癌中心灶与癌周LNM灶DI值均显著高于对照组(P<0.05),但两者之间则无显著性差异(P>0.05)。随癌周淋巴结LNM(-)→半数LNM(+)→全部LNM(+)病例,两种方法检测LNM灶的DI、SPF和PI值均逐渐增高;随着癌周LNM(+)检出率增加,无论采用组织病理学检测,还是FCM检测,患者临床分期数、病理分级数、肿瘤直径均逐渐增大,患者生存期逐渐降低。结论:采用FCM法检测食管癌周淋巴结转移情况,不仅可以提高LNM(+)检出率,而且其检测结果和癌细胞生物学特性和患者临床生物学行为的关系均比采用组织病理学方法更为密切。如果采用两种方法联合检测,更能进一步提高癌周淋巴结(+)检出率。
Objective To study the results of detection of lymphnode metastasis with convestional pathologic method and flow cytometry in patients with esophageal cnacer. Methods Both conventional pathologic and flowcytometric studies were performed on esophageal and surrounding lymphnode tissue of the resected surgical specimens in 64 patients with esophageal carcinoma. The parameters studied included cell ploidy （DNA indek）, S-nphase fraction （SFR）, proliferation index （PI） and apoptotic level （APO）. Results Taking presence of heteroploid in lymph hode cells as the positive criterion of metastasis, the positiveness of lymph node metastasis （LNM） detected with flow-cytometry （FCM） was significantly higher than that detected with conventional pathology （87.5% vs 57.8%, P〈0.05）. The DIs of the tumor proper and LNM were both higher than DI in controls （P〈0.05）, but the difference between the DIs of tumor proper and LNM was not significant. As the number of metastatic nodes increased, the cytokinetic parameters DI, SPF and PI values detected with both methods also increased correspondingly. For the esophageal tumor proper tissues with FCM, the DI, SPF and PI values all gradually increased from the lymph nodes negative group （n=8）, to half of nodes positive group （n=39） and further to all nodes positive group （n=17）. However, with conventional histopathologic method, only the DI increased gradullay from nodesnegative （n=27）, to half of nodes posstive （n=33） and to all nodes positive group （n=4） with both methods, the mean clinical stage, pathologic grading and tumor size （diameter） all gradually increased accompanied with shorter survivial peroid along with more nodal metastasis but only win FCM, a clear decrease of 5 year survival rate was demonstrated. Conclusion More positive lymph nodes metastasis could be detected with FCM than conventional pathology （in this article 56/64, 37/64）. The cytokinetic parameters detected with FCM correlated better with the clin
出处
《放射免疫学杂志》
CAS
2008年第5期442-445,共4页
Journal of Radioimmanology
关键词
食管癌
流式细胞术
组织病理学
淋巴结转移
esophageal carcinoma, flow cytometry, histopathology, lymph node metastasis
