胃癌中微小癌细胞的播散：胃系膜全层分析
Microscopic cancer cell spread in gastric cancer: whole-section analysis of mesogastrium.
作者信息
Nagatomo Atsuko, Abe Nobutsugu, Takeuchi Hirohisa, Yanagida Osamu, Masaki Tadahiko, Mori Toshiyuki, Sugiyama Masanori, Ohkura Yasuo, Fujioka Yasunori, Atomi Yutaka
机构信息
Department of Surgery, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka City, Tokyo, 181-8611, Japan.
出版信息
Langenbecks Arch Surg. 2009 Jul;394(4):655-60. doi: 10.1007/s00423-008-0427-y. Epub 2008 Oct 18.
PURPOSE
Cancer cells are often found in adipose connective tissue separate from the primary lesion and outside lymph nodes on routine pathologic examination of resected gastric cancer specimens. To identify the anatomical relationship between such cancer cell spread and lymph nodes, we investigated the microscopic cancer cell spread in the mesogastrium (CSM) by the whole-section analysis of the mesogastrium.
METHOD
One thousand five hundred fifty-two sections of the mesogastrium obtained from 37 patients with gastric cancer were subjected. CSM is defined as the existence of cancer cell spread in the mesogastrium separate from the primary lesion.
RESULTS
CSM was detected in three (8%) of the 37 patients. CSM was classified into three types. CSM was found in three of the 12 patients with advanced cancer, but not in 25 patients with early cancer.
CONCLUSIONS
CSM may occur in the mesogastrium separate from metastatic lymph nodes; therefore, we should pay particular attention to the potential existence of CSM in surgery for gastric cancer.
目的
在对切除的胃癌标本进行常规病理检查时，癌细胞常出现在与原发灶分离且位于淋巴结之外的脂肪结缔组织中。为了确定这种癌细胞扩散与淋巴结之间的解剖关系，我们通过对胃系膜进行全切片分析，研究了胃系膜中的微观癌细胞扩散情况。
方法
对37例胃癌患者的1552张胃系膜切片进行了研究。胃系膜癌细胞扩散（CSM）定义为在胃系膜中存在与原发灶分离的癌细胞扩散。
结果
37例患者中有3例（8%）检测到CSM。CSM分为三种类型。12例进展期癌症患者中有3例发现CSM，而25例早期癌症患者中未发现。
结论
CSM可能发生在与转移性淋巴结分离的胃系膜中；因此，在胃癌手术中我们应特别注意CSM的潜在存在。
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