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目的探讨鼻咽癌组织中淋巴管侵犯(LVI)与淋巴结转移之间的关系。方法用单克隆抗体D2-40及CKpan免疫组化染色检测66例鼻咽癌患者蜡块组织标本的LVI阳性率及淋巴管密度,分析LVI与LVD、淋巴结转移及临床病理特征之间的关系。结果 66例NPC组织的瘤周LVD明显高于瘤内LVD,差异有显著性意义(P<0.01);其中LVI阳性率为63.6%(42/66),LVI与瘤周LVD呈正相关(r=0.349,P<0.05),与瘤内LVD无明显关系(r=-0.340,P>0.05);淋巴结转移组LVI阳性率高于未转移组,差异有统计学意义(P<0.01);LVI预测NPC淋巴结转移的敏感性为74.5%;特异性为90.9%;阳性预测值为97.8%;阴性预测值为58.3%。LVI阳性率与N分期呈正相关,且与T分期及临床分期有关(P<0.05),而与年龄、性别及肿瘤远处转移无关(P>0.05)。结论淋巴管侵犯可作为判断鼻咽癌发生颈部淋巴结转移的重要参考指标。
Objective To investigate the relationship between lymph vessel invasion (LVI) and lymph node metastasis in nasopharyngeal carcinoma. Methods The positive rate of LVI and lymphatic vessel density in 66 cases of nasopharyngeal carcinoma patients were detected by monoclonal antibody D2-40 and CKpan immunohistochemical staining. The relationship between LVI, LVD, lymph node metastasis and clinicopathological features was analyzed. Results The LVD of tumor in 66 cases of NPC was significantly higher than that of LVD (P <0.01), the positive rate of LVI was 63.6% (42/66), LVI was positively correlated with LVD (r = 0.349, P <0.05). The positive rate of LVI in lymph node metastasis group was significantly higher than that in non-metastasis group (P <0.01) The sensitivity of NPC lymph node metastasis was 74.5%, the specificity was 90.9%, the positive predictive value was 97.8% and the negative predictive value was 58.3%. The positive rate of LVI was positively correlated with N stage and related to T stage and clinical stage (P <0.05), but not to age, sex and tumor distant metastasis (P> 0.05). Conclusion Lymphatic invasion can be used as an important reference to judge the occurrence of cervical lymph node metastasis of nasopharyngeal carcinoma.