肝门部胆管癌患者淋巴结微转移的影响
Impact of lymph node micrometastasis in hilar bile duct carcinoma patients.
作者信息
Taniguchi Kentaro, Iida Taku, Hori Tomohide, Yagi Shintaro, Imai Hiroshi, Shiraishi Taizo, Uemoto Shinji
机构信息
First Department of Surgery, Mie University School of Medicine, Tsu City, Mie Prefecture, Japan.
出版信息
World J Gastroenterol. 2006 Apr 28;12(16):2549-55. doi: 10.3748/wjg.v12.i16.2549.
AIM
To immunohistochemically examine micrometastasis and VEGF-C expression in hilar bile duct carcinoma (HBDC) and to evaluate the clinical significance of the results.
METHODS
A total of 361 regional lymph nodes from 25 patients with node-negative HBDC were immunostained with an antibody against cytokeratins 8 and 18 (CAM 5.2), and immunohistochemical staining of VEGF-C was performed in 34 primary resected tumors.
RESULTS
Lymph node micrometastasis was detected in 6 (24%) of the 25 patients and 10 (2.8%) of the 361 lymph nodes. Patients with micrometastasis showed significantly poorer survival rates than those without (P = 0.025). VEGF-C expression was positive in 17 (50%) of 34 HBDC, and significantly correlated with lymph node metastasis (P = 0.042) and microscopic venous invasion (P = 0.035).
CONCLUSIONS
It is suggested that immunohistochemically detected lymph node micrometastasis has an impact on the outcome of HBDC. VEGF-C expression is highly correlated with lymph node metastasis in HBDC and might therefore be a useful predictor.
目的
通过免疫组织化学方法检测肝门部胆管癌（HBDC）中的微转移及血管内皮生长因子-C（VEGF-C）表达，并评估结果的临床意义。
方法
对25例淋巴结阴性的HBDC患者的361个区域淋巴结用抗细胞角蛋白8和18（CAM 5.2）抗体进行免疫染色，并对34例原发性切除肿瘤进行VEGF-C免疫组织化学染色。
结果
25例患者中有6例（24%）检测到淋巴结微转移，361个淋巴结中有10个（2.8%）检测到微转移。有微转移的患者生存率明显低于无微转移的患者（P = 0.025）。34例HBDC中有17例（50%）VEGF-C表达呈阳性，且与淋巴结转移（P = 0.042）和显微镜下静脉侵犯（P = 0.035）显著相关。
结论
提示免疫组织化学检测到的淋巴结微转移对HBDC的预后有影响。VEGF-C表达与HBDC的淋巴结转移高度相关，因此可能是一个有用的预测指标。
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