Clinical Significance of Immunohistochemically-Identified Lymphatic and/or Blood Vessel Tumor Invasion in Gastric Cancer
Clinical Significance of Immunohistochemically-Identified Lymphatic and/or Blood Vessel Tumor Invasion in Gastric Cancer
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DOI：
10.1016/j.jss.2009.07.015
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发表时间：
2010-08-01
影响因子：
2.2
通讯作者：
Kim, Young-Sik
中科院分区：
文献类型：
--
作者：
Kim, Jong-Han;Park, Sung-Soo;Kim, Young-Sik
背景肿瘤浸润和淋巴结转移是影响胃癌预后的重要因素，淋巴管和血管肿瘤浸润也是胃癌复发的重要危险因素。近年来，免疫组化检测淋巴管和血管肿瘤浸润（LBVI）已被证明具有较高的敏感性和特异性比苏木精-伊红染色方法。2003年11月至2006年12月期间在高丽大学医院接受根治性切除术的149例胃癌患者作为研究对象。淋巴管浸润用新的选择性标记物D2-40免疫染色评估，血管浸润用抗CD 31抗体评估。根据LBVI的存在情况对患者进行分组，比较临床病理因素，分析术后手术效果。66例患者（44.3%）存在LBVI。LBVI与肿瘤浸润深度（P < 0.001）、淋巴结分期（P < 0.001）和淋巴结微转移（P = 0.013）显著相关。LBVI组的癌症复发更常见（P = 0.007），腹膜种植是最常见的复发类型（P = 0.028）。单因素分析显示肿瘤大小、肿瘤浸润深度、淋巴结分期和LBVI对生存率有显著影响。多因素分析显示，肿瘤浸润深度和淋巴结分期与生存率相关。LBVI的免疫组织化学证实是一个额外的预后标志物，并为胃癌患者规划治疗策略提供了有用的信息。(C)2010年爱思唯尔公司All rights reserved.
Background. Tumor invasion and lymph node metastasis are significant prognostic factors for gastric cancer, and lymphatic and vascular tumor invasion are also significant risk factors for gastric cancer recurrence. Recently, the immunohistochemical detection of lymphatic and blood vessel tumor invasion (LBVI) has been shown to have a higher sensitivity and specificity than hematoxylin-eosin staining methods.Materials and Methods. One hundred forty-nine gastric cancer patients who underwent curative resection at Korea University Hospital between November 2003 and December 2006 served as the study subjects. Lymphatic vessel invasion was evaluated by immunostaining with the new selective marker, D2-40, and blood vessel invasion was assessed with anti-CD31 antibody. Patients were divided according to the presence of LBVI, clinicopathologic factors were compared, and postoperative surgical outcomes were analyzed.Results. LBVI was present in 66 patients (44.3%). LBVI was significantly correlated with depth of tumor invasion (P < 0.001), lymph node stage (P < 0.001), and lymph node micrometastasis (P = 0.013). Cancer recurrence was more common in the LBVI group (P = 0.007), and peritoneal seeding was the most prevalent type of recurrence (P = 0.028). Univariate analysis showed tumor size, depth of tumor invasion, lymph node stage, and LBVI to have a significant impact on survival. Based on multivariate analysis, however, depth of tumor invasion and lymph node stage were correlated with survival.Conclusion. Inununohistochemical demonstration of LBVI is an additional prognostic marker, and provides useful information for planning treatment strategies in gastric cancer patients. (C) 2010 Elsevier Inc. All rights reserved.