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【目的】探讨 CK20、CEA 免疫组化检测淋巴结微转移对胃癌病理分期的影响。【方法】收集本院普外科2006年1月至2009年1月期间进行胃癌 D2根治术,且术后病理 TMN 分期为 pT1~4 N0 M0的46例胃癌患者共962枚 HE 染色阴性的淋巴结,用免疫组织化学法分别检测淋巴结细胞角蛋白20(CK20)和 CEA抗原的表达,并对该组患者进行随访。【结果】CK20及 CEA 免疫组化共发现9例患者(19.57%)共21枚淋巴结(2.18%)发生微转移,使19.57%(9/46)患者出现重新 TMN 分期。经过随访共有13例患者出现复发,微转移组的临床复发率(6/9,66.67%),明显高于无微转移组(7/37,18.92%),差异有统计学意义(P <0.05)。【结论】CK20、CEA 免疫组化是检测胃癌淋巴结微转移值得推广的方法,能更加准确地对胃癌患者的临床病理进行分期,有助于对胃癌患者预后的判断及个体化治疗方案的制定。“,”[Objective]To investigate the effects of CK20,CEA immunohistochemistry detection of lymph node micrometastases on gastric cancer pathological staging.[Methods]Cases relating to D2 radical gastrecto-my for gastric cancer were collected in the Department of general surgery of our hospital from January 2009 to January 2006,together with 46 cases of gastric cancer and the pathological TMN staging was pT1 ~4 N0 M0 ,a total of 962 HE negative lymph nodes was observed,The expression of Cell keratin 20 (CK20)and CEA anti-gen were detected by immunohistochemistry method,and the patients were followed up .[Results]A total of 9 patients (1 9.57%)was detected by CK20 and CEA immunohistochemistry approach ,and 21 lymph nodes (2.18%)with micrometastases had been detected,thus made 1 9.57% of patients (9/46)restaged.After the follow-up,a total of 13 cases of recurrence was found ,the clinical recurrence rate of the micrometastases group was 66.67% (6/9),significantly higher than that of the non metastasis group (7/37,18.92%),the difference was statistically significant.[Conclusion]CK20 and CEA immunohistochemical method is worth pro-moting to detect lymph node metastasis in gastric cancer.It can be more accurate for clinical pathological stag-ing of gastric cancer,and help to determine the prognosis of patients with gastric cancer as well as the formu-lation of individual treatment plan.