Lymph node metastases of adenocarcinoma of the esophagus and esophagogastric junction

Background Esophageal adenocarcinoma is becoming an increasingly important problem. It has been the most rapidly increasing malignancy in western countries in the last decades, and its prognosis is poor. The aim of this study was to evaluate the relationship between tumor invasion depth and lymph node metastasis for adenocarcinoma of the esophagus and esophagogastric junction, and to analyze the impact of lymph node metastases on survival of the patients.Methods The study group comprised 121 patients with adenocarcinoma of the esophagus or esophagogastric junction, who underwent esophagectomy between January 1985 and December 2003 at either the Royal Adelaide Hospital or the Flinders Medical Center, Australia. Overall, there were 101 males and 20 females, with a mean age at surgery of 62 years (range 36–80). All of them were followed up for 6 months to 13 years (mean, 6.5 years). The relationship between tumor invasion depth and lymph node metastasis, as well as between survival and lymph node metastasis in these patients were analyzed by Chi-square or Fisher’s exact test. A P<0.05 was considered statistically significant.Results The tumors were located entirely within the esophagus in 83 patients, and involved the gastro-esophageal junction in 38. The overall resection rate was 96.7% (117/121). When tumor invasion was within mucosa or submucosa of the esophagus (T(1)), the lymph node metastasis rate was 22.2% (10/45), the mean number of metastatic lymph nodes was 0.3, and the proportion of more than 4 lymph nodess metastases was 0% (0/45). When tumor invaded the adjacent structures of the esophagus (T(4)), the lymph node metastasis rate was 85.7% (6/7); the mean number of metastatic lymph nodes was 5.1, and the proportion of more than 4 lymph nodes metastases was 71.4% (5/7). There was a significant difference between T(1) and T(4) (P<0.01). The 5-year survival rate for patients without lymph node metastasis was 52.9%, for those with 1-4 nodes involved was 11.5%, and for patients with more than 4 positive nodes was 0.0% (P<0.01). Conclusions There is a close association between tumor invasion depth and lymph node metastasis for adenocarcinoma of the esophagus and esophagogastric junction. Both the number and rate of lymph node metastasis are significantly correlated to the depth of tumor invasion. Moreover, when the tumor invades deeper into the esophageal wall, the percentage of patients with more than 4 involved nodes increases. Both the lymph node status and the number of metastatic nodes are important prognostic factors for the disease.     

Proximal gastric cancer: lymph node metastatic patterns according to different T stages dictate surgical approach

Background As a common form of gastric cancer migration,lymph node metastasis largely affects the surgical treatment and prognosis of gastric cancer.Surgery is the fundamental curative option for gastric cancer that varies depending on different stages.The study aimed to compare the clinicopathological characteristics and lymph node metastatic patterns in patients of proximal gastric cancer with different T stages and investigate a reasonable radical gastrectomy approach in terms of the range of lymphadenectomy for proximal gastric cancer.Methods In our retrospective study,the data of 328 patients of proximal gastric cancer with different T stages were analyzed.By comparing the differences of lymph node metastatic rate and ratio,we investigated the clinicopathological characteristics and metastatic patterns of lymph nodes.Also,we were especially interested in the differences in survival rates between patients with and without No.5 and 6 group metastasis with the same TNM stage.Results The overall lymph node metastatic rate and ratio of advanced proximal gastric cancer were 73.4％ and 23.3％,respectively.The tumors of different T stages were statistically significant in size and differentiation degree （P ＜0.05）,multivariate analysis showed that the depth of tumor invasion was an independent risk factor for lymph node metastasis in proximal gastric cancer （RR,12.025; 95％ CI,2.326 to 62.157; P=0.003）.The overall survival rate of patients with No.5,6 group lymph node metastasis and those without was significantly different,but the differences in survival rates between patients with and without No.5 and 6 group metastasis with the same TNM stage were not statistically significant.Conclusions Different T stages in proximal gastric cancer showed different patterns and characteristics of lymph node metastasis.D2 lymphadenectomy in patients with early gastric cancer had little survival benefit because metastasis to level 2 nodes was rare.Therefore the range of the lymph node dissection in radical gastrectomy     

Clinical significance of changes in β-adrenoreceptors in peripheral lymphocytes in patients with essential hypertension

Objective To explore the relationship of β-adrenoreceptor density and function with the condition of patients with essential hypertension.Methods In the present study, 69 male patients with essential hypertension at different stages were compared with a group of age-matched normotensive controls. β-ad renoreceptor maximum bound volume (B(max)) in peripheral lymphocytes was mea sured by (3)H-dihydroalprenolol ((3)H-DHA) radio ligand binding. β- adrenoreceptor responsiveness was determined by Salbutamol (injection). Results In patients with essential hypertension at stages Ⅰ and Ⅱ, B(max) was si gnificantly higher (P<0.01 and P<0.001, respectively) and the chronot ropic doses of Salbutamol required to increase the heart rate by 30 beats/min (CD(30)) were significantly lower (P<0.01 and P<0.001, respect ively) than in age-matched normotensive control subjects. In patients with ess ential hypertension at stage Ⅲ, B(max) was significantly lower and CD(30)was significantly higher (both P<0.01) than those in the age-matched n ormotensive control subjects. B(max) was significantly higher and CD(30) was significantly lower (both P<0.001) in patients with essential hyper tensi on and with left ventricular hypertrophy (LVH) than that in patients with essent ial hypertension but without LVH. In patients with essential hypertension and heart failure, B(max) was significantly lower and CD(30) was significant ly higher (both P<0.001) than those in patients with essential hypertension without heart failure.Conclusions The changes of β-adrenoreceptor density and function were related to hypertens ion, hypertension complicated with ventricular hypertrophy, and heart failure. They may be viewed as indexes of the condition in the patients with essential hy pertension.     

Prognostic significance of metastatic lymph nodes ratio in patients with gastric adenocarcinoma after curative gastrectomy

Background We evaluated the impact of the number of metastatic lymph nodes and the metastatic lymph nodes ratio （the ratio between metastatic lymph nodes and total dissected lymph nodes,MLNR） in patients with gastric adenocaminoma following curative gastrectomy and also analyzed the relationship between the number of removed lymph nodes and prognosis in node-negative gastric cancer.Methods From January 2005 to December 2010,1 390 patients who were diagnosed with gastric adenocarcinoma and underwent curative gastrectomy were included.In particular,lymph node metastasis was not present in 515 patients.The number of metastatic lymph nodes and the metastatic lymph nodes ratio were selected for univariate and multivariate analyses to evaluate their influences on the disease outcome.The survival curve was presented according to the number of removed lymph nodes in node-negative gastric cancer using Kaplan-Meier plots.Results The overall 5-year survival rate was 54％ in this group.Univariate analysis revealed that age category,macroscopic appearance,histological grade,tumor size,depth of primary tumor invasion,number of metastatic lymph nodes,metastatic lymph nodes ratio,tumor,nodes,metastasis-classification （TNM） stage and status of lymphovascular,and vessel invasion have significant impact on survival.The number of metastatic lymph nodes and the metastatic lymph nodes ratio both have significant impact on survival （P ＜0.001）.However,in multivariate analyses,only the metastatic lymph nodes ratio was identified to be an independent prognostic factor （P ＜0.001）.The number of removed lymph nodes in node-negative was a strong prognostic factor of survival,the more lymph nodes dissected,the better the survival.Conclusions The metastatic lymph nodes ratio has more significant prognostic value for survival in patients with gastric cancer following curative gastrectomy than the number of metastatic lymph nodes.The number of removed lymph nodes miaht be an important proanostic factor for gastric cancer without lymph node metastasis.     

Pathologic features of occult lymphatic metastasis in supraglottic carcinoma

Objective　To study the pathologic features of occult lymphatic metastasis in supraglottic carcinoma. Methods　Serial sections of 153 neck dissection specimens in 100 patients with supraglottic carcinoma were evaluated under the microspcope. Results　In 100 patients, 38 had occult metastatic lymph nodes. 51 metastatic lymph nodes were found in pathology, and their sizes ranged from 0.5 cm to 2.6 cm (average 1.1 cm). The distribution of 51 lymph nodes was 1 in level Ⅰ (2%), 37 in level Ⅱ (73%), 12 in level Ⅲ (24%), and 1 in level Ⅳ (2%). Among the 51 nodes, 21 (41%) were early stage, 18 (35%) were growth stage, 7 (14%) were tull stage, and 5 (10%) were extracapsular stage. The differentiation degree and appearance of supraglottic carcinoma was not directly related with occult metastasis. Conclusion　The occult metastatic rate of supraglottic carcinoma is high, and selective neck dissection may be necessary.     

Prognostic impact of splenectomy on advanced proximal gastric cancer with No. 10 lymph node metastasis

Background This study evaluated the prognostic impact of D2 lymphadenectomy combined with splenectomy in patients with advanced proximal gastric cancer and lymph node metastasis at the splenic hilum （No. 10 lymph nodes）. Methods The clinical records of 216 patients with advanced proximal gastric cancer and No. 10 lymph node metastasis who underwent D2 curative resection were retrospectively analyzed. Seventy-three patients underwent simultaneous splenectomy （splenectomy group）, while 143 patients did not （spleen-preserving group）. Five-year survival rates, mean numbers of dissected No. 10 lymph nodes and metastatic No. 10 lymph nodes, and operative morbidity and mortality were calculated and compared between the two groups. Potential prognostic factors were evaluated by univariate and multivariate analysis.
Results The 5-year survival rate was 30.0% for the splenectomy group and 19.7% for the spleen-preserving group （χ^2=14.73, P 〈0.05）. The mean numbers of dissected No. 10 lymph nodes and metastatic No. 10 lymph nodes in the splenectomy group were significantly greater than in the spleen-preserving group （P 〈0.05）. Multivariate analysis revealed that the depth of invasion, splenectomy, and type of gastrectomy were independent prognostic factors. The survival rate for T3 patients with and without splenectomy was 38.7% and 18.9%, respectively （χ^2 =15.03, P 〈0.05）. For patients undergoing total gastrectomy, survival rates were 33.4% and 20.7%, respectively （χ^2 =13.63, P〈0.05）. Operative morbidity and mortality in splenectomy group was 24.7% and 4.1%, respectively, and in the spleen-preserving group was 17.5% and 3.5%, respectively. The differences were not statistically significant （P 〉0.05）. Conclusions Splenectomy is beneficial for No. 10 lymph node dissection in patients with advanced proximal gastric cancer. To improve patient prognosis, total gastrectomy with splenectomy is recommended for patients with T3 proximal gastric cancer who have No. 10 lymph node metastasis.     

Role of RANTES and its receptor in gastric cancer metastasis

This study examined the role of regulated upon activation normal T cell expressed and secreted(RANTES) and its receptor C-C chemokine receptor type 5(CCR5) in gastric cancer metastasis and the associated mechanism.The expression of RANTES and CCR5 was detected by using immunohistochemical staining and Western blotting in the gastric cancer tissues obtained from 60 gastric cancer patients with or without lymph node metastasis(n=30 in each).The results showed that the expression levels of RANTES and CCR5 were higher in gastric cancer with lymph node metastasis than in that without metastasis(P<0.05).The expression levels of RANTES in 30 lymph nodes with cancerous invasion were higher than in 30 normal lymph nodes(P<0.05).Chemotactic test revealed that the number of migrating gastric cancer cells(n=295.0±54.6) induced by the protein of cancer-invading lymph nodes was greater than that by the protein mixture from cancer-invading lymph nodes and RANTES antibody(n=42.5±11.6)(P<0.05).RT-PCR showed that the expression levels of the main Th1 cytokines(IL-2,γ-IFN) were lower in gastric cancer with lymph node metastasis(2.22±0.90,3.26±1.15 respectively) than in that without metastasis(3.07±1.67,4.77±1.52 respectively)(P<0.05),but the expression level of the main Th 2 cytokine(IL-10) was higher in gastric cancer with lymph nodes metastasis(6.06±2.04) than in that without metastasis(4.88±1.87)(P<0.05).It was concluded that RANTES and its receptor CCR5 may contribute to gastric cancer metastasis through influencing the balance of Th1/Th2.RANTES and CCR5 may become a marker of gastric cancer metastasis.     

Expression of p57kip2 and cyclinE proteins in human pancreatic cancer

Objective To investigate the effects of p57kip2 and cyclinE proteins on the genesis and progression of human pancreatic cancer. Methods The expression of p57kip2 and cyclinE proteins in tumor tissues and adjacent tissues of pancreatic cancer in 32 patients was detected by SP immunohistochemical technique. Results The p57kip2 protein positive-expression rate in tumor tissues of pancreatic cancer was 46.9%, which was lower than that in adjacent pancreatic tissue (P&lt;0.05). The p57kip2 protein positive-expression correlated significantly with tumor cell differentiation (P&lt;0.05) and did not correlate significantly with lymph node metastasis (P&gt;0.05). The cyclinE positive-expression rate in tumor tissues was 68.8%, which was higher than that in adjacent pancreatic tissues (P&lt;0.05). The cyclinE positive-expression also correlated significantly with tumor cell differentiation and lymph node metastasis (P&lt;0.05). The cyclinE protein positive-expression rate in the tumor tissues of the p57kip2 protein positive-expression group was lower than that in the p57kip2 protein negative-expression group, and there were no significant correlation between the two groups (r= -0.112, P＞0.05).Conclusion Decreased expression of the p57kip2 protein and/or over-expression of the cyclinE protein may play an important role in the genesis and progression of human pancreatic cancer.     

Expressions of cyclin E, cyclin dependent kinase 2 and p57KIP2 in human astric cancer

Objective To investigate the expressions of cyclin E, cyclin dependent kinase 2（CDK-2）a nd cyclin-dependent kinase inhibitor p57 (KIP2) in human gastric cancer, and to evaluate the relationships between protein levels and clinicopathological pa rameters. Methods Western blot was used to measure the expressions of cyclin E, CDK-2 and p57 (KIP2) proteins in the surgically resected gastric carcinoma, adjacent normal mu cosa and metastatic lymph nodes from 36 patients. Results Cyclin E and CDK-2 protein levels were higher in gastric cancer tissues in comp arison with normal tissues ( P &lt;0. 05).Overexpression of cyclin E was correl ated with lymph node involvement, poor histological grade and serosa invasion ( P &lt;0. 05).Overexpression of CDK-2 was correlated with lymph nodes involvem ent ( P &lt;0. 05).No statistically significant difference between cyclin E and CDK-2 expression was found when samples were stratified according to tumor siz e ( P &gt;0. 05).Expression of cyclin E and CDK-2 showed a positive linear cor relation( r =0. 451,P =0. 01).Protein levels of p57 (KIP2) were lower in gastric cancer tissues than in the normal mucosa ( P &lt;0. 05).Decreased expr ession of p57 (KIP2) was correlated with lymph node involvement ( P &lt;0. 05) .No statistically significant difference in p57 (KIP2) expression was found when sample were stratified according to tumor size, histological grade or sero sa invasion ( P &gt;0. 05).In metastatic lymph nodes, expression of cyclin E wa s increased and the expression of p57 (KIP2) decreased. Conclusion Overexpressions of cyclin E, CDK-2 and downregulated expression of p57KIP2 may play important roles in tumorigenesis and metastatic potential of gastric cancer.     

胃癌细胞DNA含量与淋巴结转移关系的初步研究

应用流式细胞术研究胃癌细胞DNA含量、S期细胞比率（SPF）和G2／M期细胞比率（G2／MPF）与胃癌淋巴结转移的关系。结果显示：异倍体胃癌淋巴结转移率及SPF显著高于二倍体胃癌（P＜0.05）。淋巴结转移个数越多，转移距离越远，也常发生在异倍体瘤。而G2／MPF则与淋巴结转移无明显关系。以上结果表明：胃癌细胞DNA含量、SPF与淋巴结转移个数、转移距离有一定关系。     

胃癌细胞DNA含量与淋巴结转移关系的初步研究

应用流式细胞术研究胃癌细胞ＤＮＡ含量、Ｓ期细胞比率（ＳＰＦ）和Ｇ２／Ｍ期细胞比率（Ｇ２／ＭＰＦ）与胃癌淋巴结转移的关系。结果显示：异倍体胃癌淋巴结转移率及ＳＰＦ显著高于二倍体胃癌（ｐ〈０．０５）。淋巴结转移个数越多，转移距离越远，也常发生在异倍体癌。而Ｇ２／ＭＰＦ则与淋巴结转移无明显关系。以上结果表明：胃癌细胞ＤＮＡ含量、ＳＰＦ与淋巴结转移个数、转移距离有一定关系。     

早期子宫颈癌中LYVE 1标记的淋巴管密度及其临床意义

目的探讨早期子宫颈癌组织中淋巴管内皮透明质酸受体 1（LYVE 1）标记的淋巴管密度（LVD）及其临床意义。方法采用免疫组织化学SP法检测41例早期子宫颈癌（Ⅰa Ⅱa）和12例正常子宫颈存档组织蜡块中LYVE 1标记的LVD，分析其与临床病理因素的关系。结果　①肿瘤组织周围淋巴管管腔扩大，形态不规则，肿瘤组织内部淋巴管管腔小，多呈闭塞状态。肿瘤组织内部淋巴管密度（ILVD）明显高于肿瘤组织周围淋巴管密度（PLVD）（P＜0.01）。ILVD和PLVD与正常子宫颈组织LVD相比均明显增加（P＜0.01）；②与无淋巴结转移者相比，有淋巴结转移者ILVD和PLVD均明显增加（P＜0.05，P＜0.01）。与无淋巴管浸润者相比，有淋巴管浸润者ILVD和PLVD均明显增加（P＜0.05，P＜0.01）。组织学分级G2、G3与G1相比，ILVD和PLVD均明显增高（P＜0.05），而G2、G3差异无统计学意义（P＞0.05）。结论早期子宫颈癌组织中ILVD和PLVD与正常子宫颈组织相比明显增加，并与淋巴结转移、淋巴管浸润等临床病理因素相关，肿瘤淋巴管生成可能在早期子宫颈癌淋巴转移过程中发挥了重要作用。     

乳腺癌腋窝淋巴结隐匿转移与肿瘤预后的关系

目的：探讨免疫组化在识别单个或微小癌巢的价值,及乳腺癌淋巴结匿转移与预后的关系。方法,选用ＨＥ切片光镜检查无腋窝淋巴结的乳腺浸润性导管癌８８例,对其腋窝淋巴结共８２３个进行光镜复查及免疫组化检查,抗体为角蛋白Ｃｙｔｏｋｅｒａｔｉｎ,并将检查结果与肿瘤大小、肿瘤内淋巴管癌栓、术后５年存活率进行对照分析。结果８８例中１９例（２１．５９％）共４１个（４．９８％）淋巴结发现Ｃｙｔｏｋｅｒａｔｉｎ阳性的隐匿     

胃癌细胞DNA流式细胞计分析在胃癌预后中的意义

对60例手术后随访超过5年以上的进展期胃癌病人的存档石蜡包埋组织按Hedey的方法进行细胞核DNA含量的FCM测定,分析DNA倍体类型与胃癌病人预后的关系。结果为DNA异倍体型胃癌的预后明显较二倍体型胃癌差,与影响胃癌病人预后的其他主要病理形态学因素进行比较发现低分化腺癌、浸润性生长、有淋巴管侵犯及淋巴结转移的胃癌预后分别较高分化腺癌、膨胀型生长、无淋巴管侵犯及无淋巴结转移的胃癌差。胃癌细胞的DNA倍体类型是另一种影响胃癌预后的独立因素。     

能谱CT成像定性评估不同分化食管癌转移淋巴结的应用价值

目的探讨能谱CT成像在定性评估不同分化食管癌转移淋巴结中的应用价值。方法回顾性分析48例经内镜病理证实的食管鳞癌病人,术前均接受能谱CT胸部平扫及双期增强扫描,测量纵隔内淋巴结短径、动脉期70 keV下的CT值（CT_{70 keV}）、动脉期及静脉期碘浓度,计算标准化碘浓度,并且与手术后病理结果相比较。结果48例食管鳞癌病人中,食管癌手术及病理证实伴淋巴结转移32例,无淋巴结转移16例。经术后病理结果确认转移淋巴结79枚,其中高、中、低分化鳞癌转移淋巴结分别为14枚、27枚和38枚;非转移性淋巴结32枚,能谱CT成像诊断淋巴结转移与手术后病理结果差异无统计学意义（P>0.05）。高中分化食管鳞癌转移性淋巴结短径、动脉期CT_{70 keV}、动静脉期标准化碘浓度均高于非转移性淋巴结（P < 0.05~P < 0.01）。低分化食管鳞癌转移性淋巴结短径、动脉期CT_{70 keV}、动静脉期NIC均高于非转移性淋巴结（P < 0.05~P < 0.01）。ROC曲线分析显示,动脉期CT_{70 keV}、动脉期标准化碘浓度及能谱曲线斜率联合诊断食管癌转移淋巴结的敏感度和特异度分别为86.1%和87.5%。结论CT能谱成像在定性评估不同分化食管癌淋巴结中具有重要价值,能够为食管癌的N分期、临床诊断及治疗方案的选择提供帮助。     

缝隙连接蛋白26和核转录因子κB在三阴性乳腺癌原发灶及淋巴结转移灶中的表达及临床意义

目的探讨缝隙连接蛋白26（connexin 26,Cx26）和核转录因子κB（nuclear factor κB,NF-κB）在三阴性乳腺癌（triple negative breast cancer,TNBC）病人原发灶和淋巴结转移灶中的表达及临床意义。方法回顾性收集经术后病理和分子分型确诊为TNBC的存档石蜡组织,原发灶共49例,其中无区域淋巴结转移者22例（A1组）,有区域淋巴结转移者27例（A2组）;将27例淋巴结转移灶作为B组。应用免疫组织化学SP染色法,检测各组中Cx26和NF-κB的表达情况,并分析二者表达的相互关系及其与临床病理特征的相关性。结果原发灶中A2组Cx26和NF-κB阳性表达率均高于A1组（P < 0.01和P < 0.05）;转移灶B组Cx26和NF-κB阳性表达率均高于原发灶A1组（P < 0.01）。Cx26蛋白表达与TNBC病人绝经状态、淋巴结转移有关（P < 0.01）,NF-κB表达与pTNM分期、淋巴结转移有关（P < 0.01和P < 0.05）。在淋巴结转移灶中,Cx26与NF-κB表达呈明显正相关关系（r=0.663,P < 0.01）。结论Cx26和NF-κB共同参与TNBC的浸润和转移,可作为预测TNBC转移复发及评估临床预后的有效指标。     

下咽鳞癌Ets-1、磷酸化STAT3的表达及其与侵袭转移的关系

目的检测转录因子Ets-1和磷酸化信号转导和转录活化因子3（P-STAT3）在下咽癌原发灶及其颈淋巴结转移灶的表达，并探讨其与下咽癌侵袭转移的关系。方法应用免疫组织化学SP法检测52例单纯手术患者下咽癌原发灶及相应36例颈淋巴结转移灶中Ets-1、P-STAT3蛋白的表达。结果在52例下咽癌原发灶中，Ets-1、P-STAT3蛋白的表达率分别为61．54％（32／52）和75．00％（39／52）；Ets-1、p-STAT3蛋白在，13～T4级下咽癌原发灶的表达率均显著高于T1—T2级（P〈0．05，P〈0．01）；在有颈淋巴结转移下咽癌原发灶的表达率均显著高于无淋巴结转移者（均P〈0．05）；Ets-1蛋白在有肺转移下咽癌原发灶的表达率显著高于无肺转移者（P〈0．05）；在36例有颈淋巴结转移下咽癌中，Ets-1、P-STAT3蛋白在转移灶的表达率分别为52．78％（19／36）和58．33％（21／36）；原发灶P-STAT3蛋白表达率显著高于转移灶（P〈0．01）。结论Ets-1和P-STAT3蛋白在下咽癌中均高表达，并与肿瘤T分级、颈淋巴结转移密切相关，Ets-1表达还与肺转移有关。Ets-1和P-STAT3有可能成为临床判断下咽癌侵袭性、转移潜能的有效指标。     

P16蛋白表达与胃癌及淋巴结转移的关系

目的：前瞻性研究抑癌基因P16蛋白在人胃癌及转移淋巴结中的表达与胃癌转移的关系。方法：应用SP免疫组织化学方法检测46例原发性胃癌及69枚转移淋巴结中P16蛋白表达。结果：P16蛋白在受检原发性胃癌中的阳性率分别为17．4％（8／46）,在转移淋巴结中的阳性率分别为19．9％（11／69）。原发癌伴淋巴结转移组P16的阳性表达率（6．9％）低于不伴淋巴结转移组的阳性率（35．3％）,差异有显著性（P＜0．05）。P16表达与肿瘤大小、部位、浸润深度、Bormann分型、年龄及性别等因素无相关性（P＞0．05）。P16在原发性胃癌及转移淋巴结中的表达无相关性（P＞0．05）。结论：P16基因蛋白对胃癌的发展及淋巴结转移有抑制作用。检测胃癌P16蛋白对评估胃癌生物学行为、预测胃癌淋巴结转移以及预后可能具有一定的价值。