Siewert J R, Kestlmeier R, Busch R, Böttcher K, Roder J D, Müller J, Fellbaum C, Höfler H
Department of Surgery, Technische Universität, Munich, Germany.
Br J Surg. 1996 Aug;83(8):1144-7. doi: 10.1002/bjs.1800830836.
A retrospective immunohistological analysis of 100 patients with pT1-3 N0 and pT1-3 N1 gastric adenocarcinoma demonstrated a high frequency of micro-involvement in the removed lymph nodes. The presence of three or more tumour cells in more than 10 per cent of the lymph nodes was of significant prognostic value in the pN0 cases. Multivariate analysis identified micro-involvement as an independent prognostic factor. The results explain why patients benefit from lymphadenectomy even if the removed lymph nodes are not involved by tumour (pN0) in routine histological examination. The frequent occurrence of micro-involvement is a strong argument favouring routine D2 lymph node dissection in gastric cancer surgery in patients with lymph node metastasis.
对100例pT1 - 3 N0和pT1 - 3 N1期胃腺癌患者进行的回顾性免疫组织学分析显示，切除的淋巴结中微转移的发生率很高。在pN0病例中，超过10%的淋巴结中存在三个或更多肿瘤细胞具有显著的预后价值。多变量分析确定微转移是一个独立的预后因素。这些结果解释了为什么即使在常规组织学检查中切除的淋巴结未被肿瘤累及（pN0），患者仍能从淋巴结清扫术中获益。微转移的频繁发生有力地支持了对有淋巴结转移的胃癌患者进行常规D2淋巴结清扫术。
