CAJ | 학술논문

目的探讨贲门癌高、低发病区淋巴结微转移的特点。方法采用免疫组织化学方法，用细胞角蛋白19（CK19）单抗和CD44v6单抗分别检测海南省农垦总医院（低发区组，48例）和河南科技大学第一附属医院（高发区组，45例）贲门癌患者常规病理学检查阴性的淋巴结微转移情况，并结合临床病理资料进行统计学分析。结果共24例（25.81%）47枚（6.99%）淋巴结存在微转移，低、高发区两组淋巴结微转移阳性率的差异有统计学意义（4.33%vs 9.46%，χ2=6.763，P=0.009），两组的临床重新分期率差异无统计学意义（18.75%vs 33.33%，χ2=2.576，P=0.108）。87例获随访，两组淋巴结微转移阳性者的复发率均明显高于微转移阴性者（P<0.05）；生存率均明显低于微转移阴性者（P<0.05）。组间比较，高发区组的复发率低于低发区组（19.05%vs 35.56%，χ2=3.986，P=0.046）。结论不论在贲门癌高、低发病区均有必要监测淋巴结微转移。贲门癌淋巴结微转移阳性者复发和死亡率高。
목적탐토분문암고、저발병구림파결미전이적특점。방법채용면역조직화학방법，용세포각단백19（CK19）단항화CD44v6단항분별검측해남성농은총의원（저발구조，48례）화하남과기대학제일부속의원（고발구조，45례）분문암환자상규병이학검사음성적림파결미전이정황，병결합림상병리자료진행통계학분석。결과공24례（25.81%）47매（6.99%）림파결존재미전이，저、고발구량조림파결미전이양성솔적차이유통계학의의（4.33%vs 9.46%，χ2=6.763，P=0.009），량조적림상중신분기솔차이무통계학의의（18.75%vs 33.33%，χ2=2.576，P=0.108）。87례획수방，량조림파결미전이양성자적복발솔균명현고우미전이음성자（P<0.05）；생존솔균명현저우미전이음성자（P<0.05）。조간비교，고발구조적복발솔저우저발구조（19.05%vs 35.56%，χ2=3.986，P=0.046）。결론불론재분문암고、저발병구균유필요감측림파결미전이。분문암림파결미전이양성자복발화사망솔고。
Objective To investigate lymph nodes micrometastases characteristics in gastric cardia adenocarcinoma(GCA) from the high and low incidence area in China. Methods Lymph nodes of patients with GCA were obtained from Hainan Provincial Nongken General Hospital (low incidence area group, 48 cases) and the First Affiliated Hospital of Henan University of Science and Technology (high incidence area group, 45 cases). Micrometastases were detected by immunohistochemical staining for the markers cytokeratin 19(CK19) and CD44 variant 6(CD44v6). The data were analyzed statistically. Results A total of 47 lymph nodes micrometastases (6.99%) from 24 patients (25.81%) were found out. The incidence of lymph nodes micrometastases was significantly different between the two groups (4.33%vs 9.46%,χ2=6.763, P=0.009). Clinical re-staging had no significant difference in the two groups (18.75%vs 33.33%,χ2=2.576, P=0.108). 87 patients were followed up, and the recurrence rate was significantly higher and survival rate was significantly lower in the positive group than in those without lymph node micrometastases (P<0.05). Recurrence rate was significantly lower in patients from the high incidence area than from the low incidence area (19.05%vs 35.56%,χ2=3.986, P=0.046). Conclusion Detecting micrometastases is necessary in GCA patients, whether from the high or low incidence. Micrometastases might correlate with worse prognosis for patients of GCA.