Sun Zhen-qing, Zhou Yan-bing
Department of General Surgery, Affiliated Hospital of Medical College of Qingdao University, Qingdao 266003, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2005 Jul;8(4):339-42.
To investigate the micrometastatic characteristics in the gastric cancer patients with negative lymph node invasion by routine pathological examination and evaluate the relationship between micrometastasis and clinicopathological features.
One hundred and thirty-eight lymph nodes from No. 7 group in 46 patients with node-negative gastric cancer by routine examination were examined by consecutive sections. Telomerase activity was determined by RT-PCR and ELISA. Clinicopathological data were analyzed by statistical method.
Micrometastasis was found in 32 lymph nodes (23.2%) from 13 cases (28.3%) by consecutive sections. Telomerase activity was positive in 49 lymph nodes (35.5%) from 20 cases (43.5%). The sensitivity, specificity, positive and negative predictive value and diagnostic accuracy of TRAP-ELISA was 100%, 84%, 65%, 100% and 88% respectively. The micrometastasis in lymph node was correlated with age, sex, primary tumor location, histological classification and metastatic lymph node type (P> 0.05), but correlated with the gross type of the primary tumor, size and serosa invasion (P< 0.05).
It is necessary to discern the micrometastasis in gastric cancer with negative lymph node by routine examination in order to objectively evaluate the clinicopathological classification and prognosis. TRAP-ELISA can be a complementary method to traditional histological examination.
探讨常规病理检查淋巴结无转移的胃癌患者的微转移特征，评估微转移与临床病理特征之间的关系。
对46例常规检查淋巴结阴性的胃癌患者第7组的138枚淋巴结进行连续切片检查。采用逆转录聚合酶链反应（RT-PCR）和酶联免疫吸附测定（ELISA）法检测端粒酶活性。采用统计学方法分析临床病理资料。
连续切片检查发现13例（28.3%）患者的32枚淋巴结（23.2%）存在微转移。20例（43.5%）患者的49枚淋巴结（35.5%）端粒酶活性呈阳性。端粒重复序列扩增-酶联免疫吸附测定（TRAP-ELISA）的敏感性、特异性、阳性预测值、阴性预测值及诊断准确性分别为100%、84%、65%、100%和88%。淋巴结微转移与年龄、性别、原发肿瘤部位、组织学分类及转移淋巴结类型无关（P>0.05），但与原发肿瘤大体类型、大小及浆膜侵犯有关（P<0.05）。
对于常规检查淋巴结阴性的胃癌患者，有必要识别微转移，以便客观评估临床病理分类及预后。TRAP-ELISA可作为传统组织学检查的补充方法。
