CAJ | 학술논문

目的探讨胃癌术后临床病理因素及淋巴结微转移对术后无瘤生存率的影响.方法选择pT1-3NoMo期胃癌患者120例,应用癌胚抗原(CEA)对所有淋巴结进行免疫组化染色,观察临床病理因素和淋巴结的CEA表达对术后无瘤生存率的影响.结果在临床病理因素中,淋巴结CEA阳性表达与肿瘤直径(P=0.011)、浸润胃壁深度(P=0.027)和淋巴管浸润(P=0.001)明显相关.术后随访(53.14±16.75)个月,胃癌患者术后无瘤生存率与肿瘤直径(P=0.018)和浸润胃壁深度(P=0.015)明显相关.淋巴结CEA表达阴性、孤立肿瘤细胞(ITCs)和微转移患者无瘤生存率分别为90.91%(80/88)、86.36%(19/22)和40.00%(4/10),微转移患者无瘤生存率明显低于ITCs(P=0.009)和淋巴结CEA表达阴性患者(P=0.000),而ITCs与淋巴结CEA表达阴性患者无瘤生存率比较差异无统计学意义(P=0.438).10例胃癌患者被检测出微转移,应划分为pN1期,重新分期率为8.33%(10/120).结论对于pT1-3N0M0期胃癌,若淋巴结中检测出微转移,其预后较差,术后复发率较高,应予以积极的化疗.
목적 탐토위암술후림상병리인소급림파결미전이대술후무류생존솔적영향.방법 선택pT1-3NoMo기위암환자120례,응용암배항원(CEA)대소유림파결진행면역조화염색,관찰림상병리인소화림파결적CEA표체대술후무류생존솔적영향.결과 재림상병리인소중,림파결CEA양성표체여종류직경(P=0.011)、침윤위벽심도(P=0.027)화림파관침윤(P=0.001)명현상관.술후수방(53.14±16.75)개월,위암환자술후무류생존솔여종류직경(P=0.018)화침윤위벽심도(P=0.015)명현상관.림파결CEA표체음성、고립종류세포(ITCs)화미전이환자무류생존솔분별위90.91%(80/88)、86.36%(19/22)화40.00%(4/10),미전이환자무류생존솔명현저우ITCs(P=0.009)화림파결CEA표체음성환자(P=0.000),이ITCs여림파결CEA표체음성환자무류생존솔비교차이무통계학의의(P=0.438).10례위암환자피검측출미전이,응화분위pN1기,중신분기솔위8.33%(10/120).결론 대우pT1-3N0M0기위암,약림파결중검측출미전이,기예후교차,술후복발솔교고,응여이적겁적화료.
Objective To investigate the influence of the lymph node micrometastasis and its clinicopathological features on postoperative disease-free survival rate for patients with gastric cancer.Methods The study included 120 patients with pT1-3NoMo gastric cancer. The relationships between clinicopathological features or carcinoembryonic antigen (CEA) positive expression and postoperative disease-free survival rate were analyzed. Results In clinicopathological factors, multivariate analysis identified CEA positive expression was significantly correlated with tumor diameter (P = 0.011 ),depth of tumor invasion (P= 0.027) and lymphatic vessel invasion (P= 0.001 ) in lymph node positively. The average postoperative follow-up was (53.14 ± 16.75) months. There was statistical correlation between the tumor diameter( P = 0.018 ) or depth of tumor invasion ( P = 0.015 ) and postoperative disease-free survival rate. The disease-free survival rate was 90.91% ( 80/88 ), 86.36% ( 19/22 )and 40.00% (4/10) for the lymph node CEA negative,isolated tumor cells (IT Cs) and micrometastasis,respectively. There was significant difference between micrometastasis and the lymph node CEA negative (P= 0.000) or ITCs (P = 0.009), however, the lymph node CEA negative and ITCs was no significant difference (P = 0.438 ). Lymph node micrometastssis of gastric cancer was detected in 10 patients who should belong to stage pN1,the restage rate was 8.33%(10/120). Conclusions If the patients were found micrometastasis in lymph node with high-risk stage pT1-3NoMo gastric cancer for whom chemotherapy may be recommended,because of its high recurrence and poor prognosis.