中华胰腺病杂志
中華胰腺病雜誌
중화이선병잡지
CHINESE JOURNAL OF PANCREATOLOGY
2009年
1期
21-23
,共3页
张波%龙江%金忱%徐近%蒋永剑%唐峰%王虹%虞先俊%傅德良%倪泉兴
張波%龍江%金忱%徐近%蔣永劍%唐峰%王虹%虞先俊%傅德良%倪泉興
장파%룡강%금침%서근%장영검%당봉%왕홍%우선준%부덕량%예천흥
胰腺肿瘤%淋巴转移%细胞角化蛋白%微转移
胰腺腫瘤%淋巴轉移%細胞角化蛋白%微轉移
이선종류%림파전이%세포각화단백%미전이
Pancreatic neoplasms%Lymphatic metastasis%Cytokeratin%Micrometastasis
目的 通过对胰头癌切除标本中淋巴结微转移的检测,分析淋巴结微转移对胰头痛临床分期及预后的影响,探讨其临床价值.方法 以手术显微镜法完整取出20例冈胰头癌行区域性胰十二指肠切除术标本中的淋巴结,常规病理检测淋巴结转移,免疫组化检测淋巴结微转移.结果 20例标本中共找到677枚淋巴结,常规病理显示13例共87枚淋巴结发生转移.在病理检测阴性的590枚淋巴结中,免疫组化检测又发现3例57枚淋巴结存在微转移.常规病理结合免疫组化检测,淋巴结转移阳性患者从65%(13/20)增加到80%(16/20);转移淋巴结的检出率从12.9%(87/677)上升到21.3%(144/677),相差显著(P<0.05).微转移检测使3例ⅡA期患者转为ⅡB期,有淋巴结微转移患者的1年内肿瘤转移、复发率为75%,而无微转移者的转移、复发率为25%.结论 胰头癌淋巴结微转移的检出有助于肿瘤分期的确定和预后的判断.
目的 通過對胰頭癌切除標本中淋巴結微轉移的檢測,分析淋巴結微轉移對胰頭痛臨床分期及預後的影響,探討其臨床價值.方法 以手術顯微鏡法完整取齣20例岡胰頭癌行區域性胰十二指腸切除術標本中的淋巴結,常規病理檢測淋巴結轉移,免疫組化檢測淋巴結微轉移.結果 20例標本中共找到677枚淋巴結,常規病理顯示13例共87枚淋巴結髮生轉移.在病理檢測陰性的590枚淋巴結中,免疫組化檢測又髮現3例57枚淋巴結存在微轉移.常規病理結閤免疫組化檢測,淋巴結轉移暘性患者從65%(13/20)增加到80%(16/20);轉移淋巴結的檢齣率從12.9%(87/677)上升到21.3%(144/677),相差顯著(P<0.05).微轉移檢測使3例ⅡA期患者轉為ⅡB期,有淋巴結微轉移患者的1年內腫瘤轉移、複髮率為75%,而無微轉移者的轉移、複髮率為25%.結論 胰頭癌淋巴結微轉移的檢齣有助于腫瘤分期的確定和預後的判斷.
목적 통과대이두암절제표본중림파결미전이적검측,분석림파결미전이대이두통림상분기급예후적영향,탐토기림상개치.방법 이수술현미경법완정취출20례강이두암행구역성이십이지장절제술표본중적림파결,상규병리검측림파결전이,면역조화검측림파결미전이.결과 20례표본중공조도677매림파결,상규병리현시13례공87매림파결발생전이.재병리검측음성적590매림파결중,면역조화검측우발현3례57매림파결존재미전이.상규병리결합면역조화검측,림파결전이양성환자종65%(13/20)증가도80%(16/20);전이림파결적검출솔종12.9%(87/677)상승도21.3%(144/677),상차현저(P<0.05).미전이검측사3례ⅡA기환자전위ⅡB기,유림파결미전이환자적1년내종류전이、복발솔위75%,이무미전이자적전이、복발솔위25%.결론 이두암림파결미전이적검출유조우종류분기적학정화예후적판단.
Objective To detect the lymph node micrometastasis in resected pancreatic head carcinoma, to investigate the role of lymphatic micrometastasis in clinical staging and predicting prognosis of the pancreatic head carcinoma. Methods Pancreaticoduodenectomy with extended lymph nodes dissection were performed in 20 patients with pancreatic head carcinoma. All the lymph nodes were taken out by operating microscope method and metastasis was diagnosed by routine histological examination with hematoxylin and eosin staining, and the presence of lymph node micrometastasis was examined by immunohistochemisty. Results A total of 677 lymph nodes were found in the 20 eases, routine histological examination revealed metastasis occurred in 87 lymph nodes in 13 cases. Of the 590 negative lymph nodes by routine histological examination, 57 lymph nodes in 3 cases were diagnosed as having micrometastasis by immunohistochemisty. With the combination of routine histological examination and immunohistochemisty, the percent of patients with positive lymph nodes increased from 65% (13/20) to 80% (16/20), the detection rate of metastasis lymph node increased from 12.9% (87/677) to 21.3% (144/677) with significant difference (P <0.05). The detection of lymph node micrometastasis changed the staging of Ⅱ A to Ⅱ B in 3 patients. Tumor metastasis and recurrence rate of patients with lymph nodes micrometastasis within one year after operation was 75%, while it was 25% of patients without lymph nodes micrometastasis. Conclusions The detection of lymph node mierometastasis metastasis was helpful in the determination of clinical staging and predication of prognosis.
