中国实用外科杂志

中国实用外科杂志 ›› 2010, Vol. 30 ›› Issue (02): 111-113.

• 论著 • 上一篇    下一篇

早期胃癌淋巴结转移相关因素分析

庞    涛，方国恩，罗天航，龚谋春，薛绪潮   

  1. 第二军医大学长海医院普通外科，上海 200433
  • 出版日期:2010-02-01 发布日期:2010-03-11

  • Online:2010-02-01 Published:2010-03-11

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摘要：

目的    探讨早期胃癌病人临床病理特征及免疫病理与淋巴结转移的相关性。方法    对2006年1月至2008年l2月第二军医大学长海医院普通外科诊治的212例早期胃癌病例进行回顾性分析，采用t检验、χ2检验和Logistic回归等统计学方法对肿瘤大小、浸润深度、组织学类型等临床病理特征以及p53、Ki?67、CAM5.2等免疫组化指标与淋巴结转移进行相关性分析。结果    肿瘤大体类型、大小、浸润深度、组织分化程度与淋巴结转移存在明显的相关性（P值为0.014、0.001，0.012，0.006，相关系数R为2.213、1.779、4.737、4.15）。免疫病理指标中p53、CAM5.2与淋巴结转移也存在明显相关（P值为0.001和0.000，相关系数R为1.922、3.632）。而年龄、性别、肿瘤位置、多发肿瘤及免疫病理指标中p16、TopoⅡ、Ki?67与淋巴结转移无明显相关性。结论    早期胃癌淋巴结转移与肿瘤大小、肿瘤分化程度、浸润深度等明显相关，可参考上述因素判断淋巴结转移风险，同时根据免疫病理指标CAM5.2、P53判断是否存在微转移可能，从而决定治疗方案。

关键词: 早期胃癌, 淋巴结转移, 免疫组化

Abstract:

The related factors study of lymph node metastasis in 212 patients with early gastric cancer        PANG Tao, FANG Guo－en, LUO Tian－hang，et al. Department of General Surgery, Changhai Hospital, the Second Military Medical Universiry, Shanghai 200433, China 
Corresponding  author ：XUE Xu－chao, E-mail: xuexch@163.com
Abstract    Objective    To observe the relationship between clinicpathological and immunopathological features of early gastric cancer (EGC) and lymph node (LN) metastasis.  Methods    A retrospective study was performed on 212 EGC patients who had been treated in the Department of General Surgery of Changhai Hospital between January 2006 and December 2008. The influence of tumor size, differentiation, macroscopic type, depth of invasion as well as CAM5.2, P53, Ki?67 expression on LN metastasis were studied by t test, χ2 test and logistic regression analysis. Results    Tumor macroscopic type, size, depth of invasion, differentiation were positively related to LN metastasis with P value of 0.014, 0.001, 0.012, 0.006 respectively, and the correlation coefficient were 2.213, 1.779, 4.737, 4.15 respectively. The expression of P53, CAM5.2 were also positively related to LN metastasis, with P value and correlation coefficient were 0.001, 0.000 and 1.922, 3.632 respectively. Age, sex, tumor location, tumor number, P16, TopoⅡ, Ki?67 were not related to LN metastasis. Conclusion    LN metastasis in EGC is mainly correlated with tumor macroscopic type, size, depth of invasion, differentiation, etc. It could evaluate the micrometastasis on the basis of CAM5.2 and P53, which should be considered when a treatment was decided.

Key words: early gastric cancer, lymph node metastasis, immunohistochemistry