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目的探讨pT3期高、中分化肠型胃癌中肿瘤出芽与淋巴结转移和淋巴管侵犯之间的关系。方法分别应用HE和免疫组化EnVision法对84例pT3期高、中分化肠型胃癌有无肿瘤出芽进行判断。结果 HE染色下肿瘤出芽发生率为52.4%(44/84),与免疫组化染色的59.5%(50/84)相仿(P>0.05)。肿瘤出芽在有淋巴管侵犯和淋巴结转移者的pT3期肠型腺癌的出芽率分别为69.6%和71.1%,明显高于无淋巴管侵犯的39.3%和无淋巴结转移者的46.2%(P<0.05);随着阳性淋巴结数目增多,高度肿瘤出芽也越多(P<0.05)。高度肿瘤出芽与淋巴管侵犯密切相关(P<0.05)。结论应用CKpan免疫染色有助于判断pT3期胃肠型腺癌肿瘤出芽;肿瘤出芽检测可有助于预测pT3期胃肠型腺癌淋巴结转移。
Objective To investigate the relationship between tumor budding, lymph node metastasis and lymphatic invasion in pT3 stage high and moderately differentiated intestinal type gastric cancer. Methods HE and immunohistochemical EnVision method were used to determine the presence or absence of tumor sprouting in 84 cases of pT3 stage high and moderate intestinal type gastric cancer. Results The incidence of tumor sprouting in HE staining was 52.4% (44/84), which was similar to 59.5% (50/84) in immunohistochemical staining (P> 0.05). The budding rates of tumor-budding in pT3 enteric adenocarcinoma with lymphatic invasion and lymph node metastasis were 69.6% and 71.1%, respectively, which were significantly higher than those in non-lymphatic invasion of 39.3% and those without lymph node metastasis (46.2%, P < 0.05). With the increase of the number of positive lymph nodes, there were more tumors in high degree of tumor (P <0.05). High degree of tumor budding and lymphatic invasion are closely related (P <0.05). Conclusion The application of CKpan immunostaining is helpful to determine the budding of pT3 gastrointestinal adenocarcinoma. The detection of tumor sprouting may be helpful to predict the lymph node metastasis of pT3 gastrointestinal adenocarcinoma.