摘要
目的探讨胃癌阴性淋巴结微转移的检测及其意义。方法应用鼠抗人细胞角蛋白(CK-19)单克隆抗体、鼠抗人癌抗原(CA72-4)单克隆抗体,免疫组化方法对65例可切除性胃癌病人的385个阴性淋巴结进行微转移检测,对相关临床病理因素及预后进行分析。结果两种单克隆抗体联合检测共检出17例(26.2%)胃癌33个(8.6%)淋巴结有微转移,淋巴结微转移与胃癌组织分型、侵袭胃壁深度有关(χ2=6.776、10.860,P<0.05)。随访28例病人,5例检出淋巴结微转移,其中无复发组2例,占9.5%(2/21);复发及死亡组3例,占42.9%(3/7),复发及死亡组微转移阳性率明显高于无复发组(χ2=3.977,P<0.05)。有微转移者5年生存率(65.3%)明显低于无转移者(87.4%),差异有显著性(χ2=16.590,P<0.01)。结论单克隆抗体联检可以提高胃癌淋巴结微转移检出率,提高临床病理分期准确性,指导术后综合治疗,并有助于判断预后。
Objective To assess the significance of detection of node-negative micrometastasis（MM） in gastric cancer.Methods By employing Cytokeratin-l9,carbohydrate antigen 72-4,and immunohistochemical staining,385 negative lymph nodes taken from resectable gastric cancer of 65 patients were detected for MM,a statistical analysis was done for its correlated factors and prognosis.Results By using the combined two monoclonal antibodies,33 lymph nodes of 17 patients（26.2%） were found to be with MM.The MM of lymph nodes was associated with the tissue typing and the depth of gastric wall was invaded（χ2=6.776,10.860;P〈0.05）.A follow-up was conducted in 28 patients,five of them were found to have MM,of whom,no recurrence was noted in two,accounting for 9.5%（2/21）;recurrence and death three,accounting for 42.9%（3/7）.The positive rate of MM in recurrence and death group was higher than that in non-recurrence group（χ2=3.977,P〈0.05）.The five-year survival in patients with MM（65.3%） was markedly lower than that without（87.4%）,the difference being significant（χ2=16.590,P〈0.01）.ConclusionThe combined monoclonal antibodies for lymph node MM may increase the detection rate of gastric cancer,increase the accuracy of clinicopathological staging,guide postoperative combined modality therapy,and conduce to judgement of the prognosis of this malignancy.
出处
《青岛大学医学院学报》
CAS
2012年第6期495-497,499,共4页
Acta Academiae Medicinae Qingdao Universitatis
关键词
胃肿瘤
淋巴转移
免疫组织化学
抗体
单克隆
stomach neoplasms
lymphatic metastasis
mmunohistochemistry
antibodies
monoclonal
