摘要
目的 通过免疫组织化学的方法检测非小细胞肺癌患者术后常规病理检查为阴性淋巴结的微转移灶 ,研究其对分期的影响。方法 以行肺癌根治性手术的 39例患者为对象 ,采用免疫组织化学角蛋白 (CK)染色的方法检测术后常规病理学检查为阴性淋巴结中的微转移灶 ,研究其检出对分期的影响。结果 在 39例患者的 90枚阴性淋巴结中 ,2 2例患者 (5 6 .4 % )的 2 6枚淋巴结 (2 8.89% )检出微转移灶。常规临床分期N0 期中 ,有淋巴结微转移灶患者的生存期 (2 7个月 )与无淋巴结微转移灶者 (5 7个月 )的差异有显著性 (P =0 .0 2 4 6 ) ;而N0 、N1期有淋巴结微转移灶患者的生存期与N2 期无淋巴结微转移灶者的差异无显著性 (P =0 .93)。有复发转移 (81% )与无复发转移 (39% )患者的淋巴结微转移率的差异有显著性 (P =0 .0 2 ) ;有、无微转移灶患者的生存期分别为 32和 4 8个月、3年生存率分别为 35 %和 75 % (P =0 .0 178)。结论 目前常规的肿瘤TMN分期方法存在一定缺陷 ,而淋巴结微转移灶的检测将有助于更精确的分期。
Objective This study was designed to estimate the impact on staging by detection of micrometastasis. Methods Specimens from 90 regional lymph nodes indicated to be tumor free by conventional histopathologic methods were taken from 39 patients who underwent pulmonary resection for non small cell lung cancer(NSCLC). These Specimens were fixed in formalin and embedded in parafin. CK immunohistochemical staining was used to detect the micrometastatic tumor cells in lymph nodes. Results Micrometastasis were found in 26 lymph nodes(28.89%) of 22 patients(56.4%). Comparision between patients with the tumor staged as N 0 or N 1 with nodal micrometastases and control patients with pathologically proved N2 stage tumor without nodal micrometastases, revealed no stastitical difference in total survival period. The duration of survival of patients with micrometastasis was significantly shorter than that of patients without micrometastasis (32 months vs. 48 months, P =0.0178). Conclusion The conventional TNM staging method has certain drawbacks and is inadequate for precise staging of NSCLC.
出处
《上海医学》
CAS
CSCD
北大核心
2003年第8期555-556,共2页
Shanghai Medical Journal
