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目的 探讨以细胞周期蛋白A、E (CyclinA、E)阳性细胞比例 (PCP)术前判断和术中指导胃癌淋巴结清扫范围的可行性。方法 2 9例行“胃癌根治切除术 (D3 )”患者 ,术前自胃镜取病灶活检组织 ,术后自标本获取正常胃粘膜、原发癌肿及淋巴结组织进行CyclinA、E阳性细胞流式细胞仪检测。无或仅有Ⅰ站淋巴结转移者为实验A组 ,有Ⅱ站或 (和 )Ⅲ站淋巴结转移者为B组。结果 ① 2 7例术前与术后获得的原发癌灶组织中CyclinA、E的PCP基本一致。其中实验A组 10例 ,B组 17例。②原发癌灶CyclinE的PCP大于 2 0 0 %者 ,A组为 2 0 0 % (2 / 10 ) ,B组为 76 5 % (13/ 17) ,两组间差异有显著性意义 (P <0 0 5 )。转移淋巴结的CyclinE明显高于对照组 ;CyclinA的PCP增高改变主要发生于原发癌灶。结论 CyclinE与胃癌进展和淋巴结转移明显相关 ;术前检测病灶活检组织中的CyclinE阳性细胞比例 ,可作为判断淋巴结转移状态的生物学指标 ,指导术中淋巴结清扫范围。
Objective To investigate the preoperative judgment of the ratio of Cyclin A (E) positive cells (PCP) and the feasibility of directing lymph node dissection in gastric cancer during operation. METHODS: Twenty-nine patients undergoing radical gastrectomy (D3) underwent gastroscopic biopsy before operation. Normal gastric mucosa, primary cancer and lymph node tissues were obtained from the specimens before and after operation. CyclinA and E positive cells flow cytometry Instrument detection. No or only Ⅰ lymph node metastasis for the experimental group A, Ⅱ or (and) Ⅲ station lymph node metastasis for the B group. Results ① The PCP of Cyclin A and E in 27 cases of primary foci obtained preoperatively and postoperatively were basically consistent. There were 10 cases in experimental group A and 17 cases in group B. (2) The PCP of the primary tumor was significantly higher than 200% in group A, 200% (2/10) in group A and 76.5% (13/17) in group B, the difference was statistically significant (P <0 0 5). The metastatic lymph nodes CyclinE was significantly higher than the control group; CyclinA PCP increased mainly occurred in the primary foci. Conclusions CyclinE is significantly associated with the progress of gastric cancer and lymph node metastasis. The proportion of CyclinE positive cells in the biopsy tissues detected before operation can be used as a biological index to judge the status of lymph node metastasis and guide the range of lymph node dissection.