Ishida K, Katsuyama T, Sugiyama A, Kawasaki S
First Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
Cancer. 1997 Mar 15;79(6):1069-76. doi: 10.1002/(sici)1097-0142(19970315)79:6<1069::aid-cncr3>3.0.co;2-b.
The clinicopathologic significance of micrometastases to lymph nodes, consisting of a single carcinoma cell or a small cluster of carcinoma cells and confirmed only by special staining, was evaluated in patients with gastric carcinoma.
The authors studied 2446 lymph nodes removed during surgery for 109 cases of gastric carcinoma, including Stages I, II, III and IV. Tissue preparations were stained with hematoxylin and eosin (H&E), Alcian blue in combination with periodic acid-Schiff stain, and antibodies against cytokeratin and carcinoembryonic antigen (CEA).
Metastases were confirmed in 230 lymph nodes (9.4%) stained with H & E, and an additional 201 lymph nodes (17.6%) had micrometastases identified only by immunostaining for cytokeratin (197 lymph nodes) and/or CEA (66). Carcinomas with micrometastases had significantly worse prognoses at Stage II. Between the two histologic types of gastric carcinoma, the diffuse type had more micrometastases than the intestinal type.
The findings of this study indicate that the presence of micrometastases in lymph nodes is an indispensable factor in determining the prognosis of gastric carcinoma patients.
对仅通过特殊染色确诊的、由单个癌细胞或一小簇癌细胞组成的胃癌淋巴结微转移的临床病理意义进行了评估。
作者研究了109例胃癌手术切除的2446个淋巴结，包括I、II、III和IV期。组织切片用苏木精和伊红（H&E）、阿尔辛蓝与过碘酸希夫染色联合染色，以及抗细胞角蛋白和癌胚抗原（CEA）抗体染色。
H&E染色确诊转移的淋巴结有230个（9.4%），另外201个淋巴结（17.6%）仅通过细胞角蛋白免疫染色（197个淋巴结）和/或CEA免疫染色（66个淋巴结）发现有微转移。II期有微转移的癌患者预后明显较差。在两种组织学类型的胃癌中，弥漫型比肠型有更多的微转移。
本研究结果表明，淋巴结微转移的存在是决定胃癌患者预后的一个不可或缺的因素。
