Department of General Surgery, The First Affiliated Hospital, Dalian Medical University, Dalian, China.
J Surg Oncol. 2011 Jan 1;103(1):53-6. doi: 10.1002/jso.21755.
The clinical significance of lymph node micrometastasis (MM) for pN0 early gastric cancer is not well documented. The aim of this study is to clarify the risk factors of lymph node MM and the prognostic significance of the type of lymph node MM in patients with pN0 early gastric cancer.
We investigated the lymph node MM with using an anticytokeratin immunohistochemical stain in 160 patients with pN0 early gastric cancer who underwent curative resection between 2000 and 2005.
We identified lymph node MM in 34 of 160 patients (21.3%), and in 84 of 1,656 lymph nodes (5.1%). MM occurred as single-cell type in 10 patients and as cell cluster type in 24 patients. MM was significantly associated with tumor size (P = 0.041) and lymphatic invasion (P = 0.008). The statistically significant prognostic factors affecting 5-year survival rates were depth of tumor invasion (P = 0.020), tumor size (P = 0.035), lymphatic invasion (P = 0.018), MM (P < 0.001), and type of MM (P < 0.001). Cox regression survival analysis revealed that the presence of MM, and particularly the cluster-type MM (P < 0.001), were independent prognostic factors in pN0 early gastric cancer patients.
The incidence of lymph node MM in patients with node negative early gastric cancer was 21.3%, and cancer cell cluster type of MM proved a primary independent prognostic factor for pN0 early gastric cancer patients.
淋巴结微转移（MM）对 pN0 早期胃癌的临床意义尚未得到充分证实。本研究旨在阐明 pN0 早期胃癌患者淋巴结 MM 的危险因素以及淋巴结 MM 类型的预后意义。
我们调查了 160 例 2000 年至 2005 年间接受根治性切除术的 pN0 早期胃癌患者的淋巴结 MM，使用抗细胞角蛋白免疫组化染色。
我们在 160 例患者中的 34 例（21.3%）和 1656 个淋巴结中的 84 个（5.1%）中发现了淋巴结 MM。MM 以单细胞类型发生在 10 例患者中，以细胞簇类型发生在 24 例患者中。MM 与肿瘤大小（P=0.041）和淋巴管浸润（P=0.008）显著相关。影响 5 年生存率的统计学显著预后因素包括肿瘤浸润深度（P=0.020）、肿瘤大小（P=0.035）、淋巴管浸润（P=0.018）、MM（P<0.001）和 MM 类型（P<0.001）。Cox 回归生存分析显示，MM 的存在，特别是簇状 MM（P<0.001），是 pN0 早期胃癌患者的独立预后因素。
淋巴结阴性早期胃癌患者的淋巴结 MM 发生率为 21.3%，癌细胞簇状 MM 是 pN0 早期胃癌患者的主要独立预后因素。
