CAJ | 학술논문

目的：分析淋巴结微转移在贲门癌病理分期上的临床意义。方法收集2005年1月至2009年12月间海南省农垦总医院行根治性手术的48例PT1-4N0贲门癌患者临床资料，共获取常规病理学检查阴性的淋巴结323枚。采用免疫组织化学方法，用细胞角蛋白19（CK19）单抗和CD44v6单抗对淋巴结进行检测，并结合临床病理资料进行统计学分析。结果共9例（18.75%）14枚淋巴结（4.33%）发现微转移。有9例分期得到提高，重新分期率为18.75%。其中ⅠA→ⅠB期1例，ⅠB→ⅡA期3例，ⅡA→ⅡB期3例，ⅡA→ⅢA期1例，ⅡB→ⅢB期1例。微转移组的临床复发率明显高于无微转移组（66.67%vs 27.78%，χ2=4.752，P=0.029），5年生存率差异有统计学意义（16.67%vs 64.71%，P=0.001）。结论免疫组织化学方法可以提高贲门癌患者淋巴结转移的检出率，有助于更准确地进行临床病理分期。
목적：분석림파결미전이재분문암병리분기상적림상의의。방법수집2005년1월지2009년12월간해남성농은총의원행근치성수술적48례PT1-4N0분문암환자림상자료，공획취상규병이학검사음성적림파결323매。채용면역조직화학방법，용세포각단백19（CK19）단항화CD44v6단항대림파결진행검측，병결합림상병리자료진행통계학분석。결과공9례（18.75%）14매림파결（4.33%）발현미전이。유9례분기득도제고，중신분기솔위18.75%。기중ⅠA→ⅠB기1례，ⅠB→ⅡA기3례，ⅡA→ⅡB기3례，ⅡA→ⅢA기1례，ⅡB→ⅢB기1례。미전이조적림상복발솔명현고우무미전이조（66.67%vs 27.78%，χ2=4.752，P=0.029），5년생존솔차이유통계학의의（16.67%vs 64.71%，P=0.001）。결론면역조직화학방법가이제고분문암환자림파결전이적검출솔，유조우경준학지진행림상병리분기。
Objective To evaluate the significance of lymph node micrometastasis in determining the stage of gastric cardia adenocarcinoma(GCA). Methods Three hundred and twenty-three lymph nodes from 48 GCA patients with negative lymph node by routine pathological examination were examined immunohistochemically(IHC) for the lymph nodes micrometastasis using anti-CK19 and anti-CD44v6 monoclonal anti-body. Clinical data were analyzed by statistical methods. Results Micrometastasis was found in 14 lymph nodes (4.33%) from 9 cases (18.75%). Nine of those patients were up-staged(from stageⅠA toⅠB in one patient, stageⅠB to ⅡA in three patients, stageⅡA to ⅡB in three patients, stageⅡA toⅢA in one patient, stageⅡB toⅢB in one patient). The rate of restaging was 18.75%. Conclusion IHC assay can increase the detection rate of lymph node metastasis and has a significant impact on the staging of GCA.