Yasuda Kazuhiro, Adachi Yosuke, Shiraishi Norio, Inomata Masafumi, Takeuchi Hiroaki, Kitano Seigo
Department of Surgery I, Oita Medical University, Oita, Japan.
Ann Surg Oncol. 2002 Oct;9(8):771-4. doi: 10.1007/BF02574499.
There is no consensus as to the impact of lymph node micrometastasis on survival of patients with gastric cancer. The aim of this study was to clarify the prognostic significance of lymph node micrometastasis in patients with histologically node-negative gastric cancer.
Lymph nodes (n = 2039) from 64 patients with histologically node-negative gastric cancer (T2, T3) were evaluated for micrometastasis. Three serial 5- micro m sections of the resected lymph nodes were prepared for immunohistochemical staining with the anti-cytokeratin antibody CAM 5.2.
Micrometastasis was found in 73 of 2039 nodes (4%) and 20 of 64 patients (32%). The 5-year survival rate was significantly lower for patients with lymph node micrometastasis than for those without lymph node micrometastasis (66% vs. 95%, P <.01). The 5-year survival rate was significantly lower when there were four or more positive micrometastatic nodes (94% vs. 29%, P <.01) and when there were extragastric micrometastatic nodes (89% vs. 53%, P <.01).
Lymph node micrometastasis was associated with poor outcome in patients with histologically node-negative gastric cancer. The number and the level of lymph node micrometastases are useful prognostic markers for deciding treatment strategies for additional therapy and follow-up.
关于淋巴结微转移对胃癌患者生存的影响尚无共识。本研究的目的是阐明组织学上淋巴结阴性的胃癌患者中淋巴结微转移的预后意义。
对64例组织学上淋巴结阴性的胃癌（T2、T3）患者的2039个淋巴结进行微转移评估。将切除的淋巴结制作三个连续的5微米切片，用抗细胞角蛋白抗体CAM 5.2进行免疫组织化学染色。
在2039个淋巴结中的73个（4%）以及64例患者中的20例（32%）发现了微转移。有淋巴结微转移的患者5年生存率显著低于无淋巴结微转移的患者（66%对95%，P<.01）。当有四个或更多阳性微转移淋巴结时（94%对29%，P<.01）以及当有胃外微转移淋巴结时（89%对53%，P<.01），5年生存率显著降低。
组织学上淋巴结阴性的胃癌患者中，淋巴结微转移与不良预后相关。淋巴结微转移的数量和水平是决定额外治疗和随访治疗策略的有用预后标志物。
