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目的 Dukes’B期结直肠癌患者手术后 5年生存率为 5 3.9%～ 84 .9% ,有部分患者 5年内出现局部复发或 /和远处转移。该研究旨在探讨淋巴结微小转移灶 (lymphnodemicrometastasisLMM)及原发灶P5 3的表达对评估经手术切除原发肿瘤及肠周淋巴结的Dukes’B期结直肠癌患者预后的重要性。方法 收集 5 2例Dukes’B期结直肠癌患者手术切除的淋巴结及原发灶石蜡标本 ,同时获得这些病例的临床资料及随访资料 ;实验方法 :以细胞角蛋白单抗AE1/AE3 为探针 ,采用免疫组化SAP(streptavidin -alkalinephosphatase)法检测淋巴结中的LMM。以P5 3单抗为探针 ,采用免疫组化S -P(streptavidin -peroxidase)法检测原发灶P5 3蛋白的表达。结果 检测 5 2例Dukes’B期结直肠癌患者的 5年生存率为 73%。淋巴结中LMM +组 5年生存率 4 5 .5 % ,LMM -组 78.9%。原发灶中P5 3+组 5年生存率 6 2 .5 % ,P5 3-组 87.5 %。同时检测LMM +P5 3+组33% ,LMM -P5 3-组 84 %。χ2 检验均P <0 .0 5 ,生存分析log-rank检验P <0 .0 5。结论 用免疫组化法检测Dukes’B期结直肠癌患者经手术切除后肠周淋巴结中的微小转移灶及原发灶P5 3蛋白对判断患者预后及指导术后治疗均有临床意义。
Objective To investigate the 5-year survival rate of patients with Dukes’B stage colorectal cancer after operation from 5 3.9% to 84.9%. Some patients experienced local recurrence and / or distant metastasis within 5 years. The purpose of this study was to investigate the importance of lymph node micrometastasis (LML) and primary tumor P53 expression in assessing the prognosis of patients with Dukes’B stage colorectal cancer who underwent surgical resection of the primary tumor and peri-intestinal lymph nodes. Methods Lymph nodes and primary paraffin specimens from 52 patients with Dukes’B stage colorectal cancer were collected and the clinical data and follow-up data of these cases were obtained. Methods: Using cytokeratin AE1 / AE3 as probe The LMM in lymph nodes was detected by streptavidin-alkaloid phosphatase (SAP). Using P5 3 monoclonal antibody as a probe, the expression of P53 protein was detected by streptavidin-peroxidase (S-P) method. Results The 5-year survival rate of 52 patients with Dukes’B colorectal cancer was 73%. The 5-year survival rate was 45.5% in the LMM + group and 78.9% in the LMM-group. The 5-year survival rate of P5 3+ group was 62.5% in the primary tumor and 87.5% in the P5 3- group. At the same time, 33% of LMM + P5 3+ group and 84% of LMM-P5 3- group were detected. χ2 test were P <0. 05, survival analysis log-rank test P <0. Conclusion Immunohistochemical detection of Dukes’B colorectal cancer patients after surgical resection of the small intestine lymph node micrometastases and P5 3 protein in the prognosis of patients with prognosis and guidance of postoperative treatment are of clinical significance.