胃下部癌常规病理阴性No.9组淋巴结微转移研究_医学论文.docVIP

胃下部癌常规病理阴性No.9组淋巴结微转移研究_医学论文 胃下部癌常规病理阴性No.9组淋巴结微转移研究_医学论文 作者：徐克锋 周岩冰 刘相萍 李玉军 从林 李宇 【摘要】 目的 检测胃下部癌常规病理阴性No.9组淋巴结微转移情况，并分析淋巴结微转移与临床病理因素的关系。方法 分别应用淋巴结组织连续切片法和端粒重复序列扩增(TRAP)酶联免疫吸附试验(ELISA)方法，检测41例胃下部癌病人No.9组82枚常规病理阴性的淋巴结(每例2枚)，结合临床病理资料进行统计分析。结果 连续切片法检测发现3例病人4枚淋巴结发生微转移，对该4枚淋巴结行端粒酶活性检测，结果均呈阳性。对连续切片阴性者检测发现另有8例病人的13枚淋巴结发生微转移，两种检测方法的差异具有显著性(χ2=6.125，0.05)。本组病人No.9组淋巴结微转移率为26.83%(11/41)，其淋巴结微转移度为20.73%(17/82)。淋巴结微转移与病人年龄、性别、分化程度差异无统计学意义(χ2=0.322～1.328，Pgt0.05)，但与原发肿瘤大体分型、肿瘤直径、浸润深度及临床分期有关(χ2=5.455～8.389，0.05)。结论 胃下部癌病人No.9组淋巴结有较高的微转移率，建议对常规病理检查无淋巴结转移病人行微转移检测，以准确分期及指导治疗。 【关键词】 胃肿瘤肿瘤转移病理学淋巴结 [ABSTRACT] Objective To investigate the lymph node micrometastasis of negative group Methods Serial sections and telomeric repeat amplication protocol (TRAP)enzyme linked immunosorbent assay (ELISA) were applied to detect lymph node micrometastasis of 82 negative lymph nodes in 48 patients (two in each case) with lowerpart gastric cancer,the data was analyzed statistically. Results Micrometastasis was found in four lymph nodes (3 cases) by serial sections and by TRAPELISA. For negative lymph nodes on conventional pathology, 13 lynph nodes (8 cases) were found positive by TRAPELISA, the difference between the two methods were significant (χ2=6.125,0. 05). In the present study, the micrometastasis rate of group9 lymph nodes was26.83%(11/41) and the ratio of lymph node micrometastasis was 20.73%(17/82). The differences among micrometastasis, patient’s age,gender and histological differentiation were not statistically significant (χ2=0.322-1.328,Pgt0. 05),but were associated with gross typing and diameter of the tumor,depth of infiltration and TNM staging (χ2=5.455-8.389,0.05). Conclusion Group9 lymph nodes in lowerthird gastric cancer have a relatively higher rate of micrometastasis. For a negative lymphnode findings, micrometastasis check is recommended for exact staging and therapy. 　　[KEY WORDS] Stomach neoplasms Neoplasm metastasis Pathology Lymph nodes 　　1977年，ATTIYEHF等[1]首次报道