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目的:探讨D2-40标记食管鳞癌淋巴管浸润(LVI)的临床病理意义。方法:应用免疫组织化学S-P法检测107例食管鳞癌D2-40蛋白表达并观察淋巴管受肿瘤细胞浸润的情况,分析其与食管鳞癌临床病理因素之间的关系,观察患者总生存期。结果:食管鳞癌组织LVI阳性组淋巴结转移率70%,LVI阴性组淋巴结转移率21%,LVI阳性组转移率高于阴性组,多因素分析显示两组间差异有统计学意义(P<0.001)。LVI阳性组中位生存时间为26个月,LVI阴性组中位生存时间43个月,单因素分析显示两组间差异有统计学意义(P=0.014),多因素分析显示LVI不能成为食管鳞癌术后患者预后的独立危险因素(P=0.062),淋巴转移(P=0.031)、临床分期(P=0.019)和肿瘤残留(P=0.026)是预后的独立危险因素。结论:D2-40标记的LVI可以预测食管鳞癌患者的淋巴结转移。
Objective: To investigate the clinicopathological significance of D2-40-labeled lymphatic invasion (LVI) in esophageal squamous cell carcinoma. Methods: The expressions of D2-40 protein in 107 esophageal squamous cell carcinomas were detected by immunohistochemical S-P method and the infiltration of lymphatic vessels by tumor cells was observed. The relationship between them and the clinicopathological parameters of esophageal squamous cell carcinoma was analyzed, and the overall survival was observed. Results: The rate of lymph node metastasis was 70% in LVI positive group and 21% in LVI negative group, and the metastasis rate in LVI positive group was higher than that in negative group. Multivariate analysis showed that there was significant difference between the two groups (P <0.001) ). The median survival time was 26 months in LVI positive group and 43 months in LVI negative group. Univariate analysis showed that the difference between the two groups was statistically significant (P = 0.014). Multivariate analysis showed LVI could not become esophageal squamous cell carcinoma The independent risk factors of prognosis in patients with cancer after surgery were independent risk factors (P = 0.062), lymph node metastasis (P = 0.031), clinical stage (P = 0.019) and tumor residual (P = 0.026). Conclusions: D2-40 labeled LVI can predict lymph node metastasis in patients with esophageal squamous cell carcinoma.