Micrometastasis in lymph nodes of mucosal gastric cancer
Micrometastasis in lymph nodes of mucosal gastric cancer
复制标题
粘膜胃癌淋巴结微转移
DOI：
10.1007/pl00011702
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发表时间：
2000
期刊：
影响因子：
7.4
通讯作者：
N. Kaibara
中科院分区：
文献类型：
--
作者：
Jianhui Cai;M. Ikeguchi;S. Tsujitani;M. Maeta;N. Kaibara
背景。内镜下粘膜切除术是治疗粘膜性胃癌的常用方法。粘膜胃癌淋巴结微转移尚不清楚。我们检查了84例粘膜胃癌患者的2526个淋巴结。连续制备两张切片，分别用苏木精和伊红同时染色，用CAM 5.2单克隆抗体抗细胞角蛋白（CK）免疫染色。对有无淋巴结累及的患者进行了临床病理比较。2526个淋巴结中有45个（1.8%）淋巴结受累。淋巴结受累的发生率显著增加，从苏木精和伊红染色的1.2%（1/84例）增加到CK免疫染色的19%（16/84例）。虽无统计学差异，但大于1.0 cm的肿瘤（15/72例，21%）较小于或等于1.0 cm的肿瘤（1/12例，8%,P = 0.307）多发淋巴结微转移。然而，仅在大于2 cm的肿瘤中检测到离散的ck阳性癌细胞或成群的ck阳性癌细胞。由于表面直径大于1.0 cm的粘膜胃癌可能提示有淋巴结微转移的危险，因此不建议对这些患者进行内镜粘膜切除术。
Background. Endoscopic mucosal resection is frequently used in the treatment of mucosal gastric cancer. Micrometastasis in the lymph nodes of mucosal gastric cancer remains unclear.Methods. We examined 2526 lymph nodes from 84 patients with mucosal gastric cancer. Two consecutive sections were prepared, for simultaneous staining with hematoxylin and eosin and immunostaining with CAM 5.2 monoclonal antibody against cytokeratin (CK), respectively. A clinicopathological comparison was made between patients with and without lymph node involvement.Results. Lymph node involvement was detected in 45 of 2526 (1.8%) lymph nodes. The incidence of nodal involvement was significantly increased, from 1.2% (1/84 patients) with hematoxylin and eosin staining, to 19% (16/84 patients) with CK immunostaining. Although no significant difference was found, micrometastasis to lymph nodes was more frequently detected in tumors larger than 1.0 cm (15/72 patients, 21%) than in those less than or equal to 1.0 cm (1/12 patients; 8%, P = 0.307). However, discrete CK-positive cancer cells or clusters of CK-positive cancer cells were detected only in tumors larger than 2 cm.Conclusion. Because mucosal gastric cancer of more than 1.0 cm in superficial diameter may indicate a risk of micrometastasis to lymph nodes, endoscopic mucosal resection is not recommended for these patients.