Palma R T, Waisberg J, Bromberg S H, Simão A B, Godoy A C
Department of Gastrointestinal Surgery, Hospital do Servidor Público Estadual de São Paulo, Rua Padre Manoel de Paiva 264 Ap. 32, Santo André, São Paulo 09070-230, Brazil.
Colorectal Dis. 2003 Mar;5(2):164-8. doi: 10.1046/j.1463-1318.2003.00414.x.
The main objectives of this study were to identify, by immunohistochemistry, possible micrometastasis in the regional lymph nodes previously considered free by conventional histopathological examination, and to assess their influence on the survival of patients with colorectal cancer that had been extirpated in a radical manner.
From 38 patients with Dukes B staging (Colorectal Carcinoma Stage II (T3 N0 M0 or T4 N0 M0)) colorectal carcinoma, 383 lymph nodes were studied in paraffin blocks that had previously been considered free by conventional histopathological examination. These were submitted to immunohistochemical study using AE1/AE3 anti-cytokeratin monoclonal antibodies to identify neoplastic epithelial cells.
Seven lymph nodes (1.82%) in six patients (15.78%) contained micrometastasis. The survival of the patients with extirpated colorectal carcinoma staged as Dukes B who had lymph node metastasis was less than in the group of patients without micrometastasis, although these values were not statistically significant.
This immunohistochemical method can be employed successfully in the detection of neoplastic cells in lymph nodes previously considered free. In this study, there was a trend towards lower survival in node-positive patients but this did not reach statistical significance.
本研究的主要目的是通过免疫组织化学方法，在以往经传统组织病理学检查认为无转移的区域淋巴结中识别可能存在的微转移，并评估其对已行根治性切除的结直肠癌患者生存的影响。
选取38例处于Dukes B期（结直肠癌II期（T3 N0 M0或T4 N0 M0））的结直肠癌患者，对其之前经传统组织病理学检查认为无转移的石蜡包埋淋巴结共383个进行研究。使用抗细胞角蛋白单克隆抗体AE1/AE3对这些淋巴结进行免疫组织化学研究，以识别肿瘤上皮细胞。
6例患者（15.78%）的7个淋巴结（1.82%）存在微转移。行根治性切除的Dukes B期结直肠癌且有淋巴结转移患者的生存率低于无微转移患者组，尽管这些数值无统计学意义。
这种免疫组织化学方法可成功用于检测以往认为无转移的淋巴结中的肿瘤细胞。在本研究中，淋巴结阳性患者的生存率有降低趋势，但未达到统计学意义。
