CAJ | 학술논문

目的研究喉鳞状细胞癌(简称鳞癌)患者存在颈部淋巴结微小转移灶与患者的预后以及生存率之间的关系.方法对126例喉鳞癌患者择区性(Ⅱ、Ⅲ、Ⅳ区)颈淋巴清扫标本进行HE染色,将HE染色阴性的淋巴结连续6次切片,3张行HE染色,3张行细胞角蛋白(cytokeratin,CK)AE1/AE3抗体免疫组化染色；对HE染色阳性的淋巴结再次行CK AE1/AE3抗体免疫组化染色.本组患者随访24 ～ 184个月,平均随访6.3年,复发与转移计入随访.Kaplan-Meier法计算生存率.结果 126例喉鳞癌患者接受喉部手术与颈部择区性淋巴清扫术,41例患者淋巴结HE染色阳性,85例患者HE染色阴性.85例HE染色阴性患者中,33例CK染色阳性,52例阴性.15例HE染色阳性、14例CK染色阳性和4例CK染色阴性患者在随访中发生复发或转移.本组患者的5年生存率79.8％,10年生存率60.5％.CK染色阳性患者的10年生存率为52.1％,低于CK染色阴性患者的81.2％,差异有统计学意义(P＜0.01).结论 CK免疫组化染色是一种寻找喉鳞癌患者淋巴结微小转移灶的有效方式.CK AE1/AE3染色阳性与喉癌患者的预后有关.
목적 연구후린상세포암(간칭린암)환자존재경부림파결미소전이조여환자적예후이급생존솔지간적관계.방법 대126례후린암환자택구성(Ⅱ、Ⅲ、Ⅳ구)경림파청소표본진행HE염색,장HE염색음성적림파결련속6차절편,3장행HE염색,3장행세포각단백(cytokeratin,CK)AE1/AE3항체면역조화염색；대HE염색양성적림파결재차행CK AE1/AE3항체면역조화염색.본조환자수방24 ～ 184개월,평균수방6.3년,복발여전이계입수방.Kaplan-Meier법계산생존솔.결과 126례후린암환자접수후부수술여경부택구성림파청소술,41례환자림파결HE염색양성,85례환자HE염색음성.85례HE염색음성환자중,33례CK염색양성,52례음성.15례HE염색양성、14례CK염색양성화4례CK염색음성환자재수방중발생복발혹전이.본조환자적5년생존솔79.8％,10년생존솔60.5％.CK염색양성환자적10년생존솔위52.1％,저우CK염색음성환자적81.2％,차이유통계학의의(P＜0.01).결론 CK면역조화염색시일충심조후린암환자림파결미소전이조적유효방식.CK AE1/AE3염색양성여후암환자적예후유관.
Objective To analyse the correlation between the micrometastasis and early recurrence and prognosis in laryngeal cancer.Methods Total of 126 patients with laryngeal squamous cell carcinoma were included in the study.The micrometastasis was detected with hematoxylin and eosin staining(HE) and immunohistochemical staining for cytokeratin (CK) of the lymph node specimens after selective neck dissection( Ⅱ -Ⅳ).Chi-square test was used to analyse the relationship between the micrometastasis and early recurrence and prognosis,and Kaplan-Meier method was used for survival analysis.Results HE staining showed positive micrometastasis in 41 cases and negative micrometastasis in 85 cases in which 33 cases were positive staining for CK. With a following-up of mean 6.3 years,recurrence or metastasis occurred in 15 cases with positive micrometastasis detected by HE staining,14 cases with CK positive staining and 4 cases with CK negative staining.The correlation between micrometastasis and early recurrence was significant(P ＜ 0.01 ).The total 5-year survival rate was 79.8％,10-year survival rate was 60.5％.The 10-year survival rate(52.1％ ) of the patients with CK positive staining indicating micrometastasis was significantly higher than that of CK negative patients (81.2％,P ＜ 0.01 ). Conclusion Cervical micrometastasis predicts poor prognosis and early recurrence in patients with laryngeal squamous cell carcinoma.