胃癌局部神经侵犯的临床意义

目的探讨胃癌患者根治术后病理局部神经侵犯(PNI)的临床意义。方法对110例行胃癌根治术患者的病理组织行苏木素-伊红(HE)染色,当肿瘤细胞侵犯神经束或神经束膜时,判断为PNI阳性,分析PNI与胃癌临床病理特征之间的关系。结果 PNI阳性49例。PNI与肿瘤大小、浸润深度、区域淋巴结转移、TNM分期、脉管癌栓、断端阳性有显著相关性,但与性别、年龄、肿瘤部位及远处转移无相关性。虽然PNI与胃癌患者预后密切相关,但不是影响预后的独立因素。结论胃癌周围神经侵犯与肿瘤的进展密切相关,其有可能作为新的标准完善胃癌的分期。

Clinical Significance of Stomach Cancer Local Nerve Invasion

Objective The prognostic signiifcance of perineural invasion （PNI） in gastric carcinoma has been previously investigated in a few studies, but has not reached a consensus. The aim of this study was to determine the clinical signiifcance of PNI in patients with gastric carcinoma who underwent curative resection. Methods We retrospectively analyzed 110 patients who had undergone curative gastrectomy. Paraffin sections of gastric carcinoma tissues from all patients were stained with hematoxylin and eosin. PNI was assessed as positive when cancer cells were seen in the perineurium or neural fascicles. The relationship between PNI and the other clinicopathologic features of gastric carcinoma was studied. Results PNI was detected as positive in 49 of the 110 patients. PNI was closely related to tumor size, depth of invasion, lymph node metastasis, TNM stage, lymphatic vessel and blood vessel invasion, positive surgical margins; however, PNI showed no correlation to age, gender, tumor location, and distant metastasis. Despite the prognostic value of PNI, our results suggest PNI is not an independent prognostic factor. Conclusions PNI was closely related to the progression of gastric carcinoma, and it may improve accuracy of the staging of gastric carcinoma.