Kamata T, Yonemura Y, Sugiyama K, Ooyama S, Kosaka T, Yamaguchi A, Miwa K, Miyazaki I
Second Department of Surgery, School of Medicine, Kanazawa University, Japan.
Cancer. 1989 Oct 15;64(8):1665-8. doi: 10.1002/1097-0142(19891015)64:8<1665::aid-cncr2820640818>3.0.co;2-6.
Forty seven patients with early gastric cancer received a 30-minute intravenous injection of bromodeoxyuridine (BrdU), 1000 mg each 1 hour before laparotomy, to label tumor cells in the S phase. In 13 of 47 patients, specimens obtained by endoscopic biopsy were cultured in vitro at 37 degrees C for 1 hour under three times the atmospheric pressure in a vial with 400 microM BrdU. Labeled cells were detected in the resected specimen and the cultured specimen by immunohistochemical staining procedure. The BrdU labeling index (LI, defined as the percentage of labeled cells in relation to the 1000 tumor cells) was calculated for each specimen. All patients without lymph node metastasis had an in vivo BrdU LI of less than 12%. In contrast, 31% of patients with early gastric cancer with an in vivo BrdU LI greater than 12% had lymph node metastasis. There was a correlation between the in vivo and the in vitro LI. Therefore, the in vitro BrdU LI of specimens obtained by endoscopic biopsy may be a useful indicator of lymph node status in patients with individual early gastric cancers before operations. If the in vitro BrdU LI is less than 12% lymph node dissection may not be necessary.
47例早期胃癌患者在剖腹手术前1小时接受30分钟的溴脱氧尿苷（BrdU）静脉注射，剂量为每次1000毫克，以标记处于S期的肿瘤细胞。在47例患者中的13例中，将通过内镜活检获得的标本在37℃下于装有400微摩尔BrdU的小瓶中在三倍大气压下体外培养1小时。通过免疫组织化学染色程序在切除的标本和培养的标本中检测标记细胞。计算每个标本的BrdU标记指数（LI，定义为标记细胞相对于1000个肿瘤细胞的百分比）。所有无淋巴结转移的患者体内BrdU LI均小于12%。相比之下，体内BrdU LI大于12%的早期胃癌患者中有31%发生了淋巴结转移。体内和体外LI之间存在相关性。因此，内镜活检获得的标本的体外BrdU LI可能是个体早期胃癌患者术前淋巴结状态的有用指标。如果体外BrdU LI小于12%，可能无需进行淋巴结清扫。
