肺癌患者淋巴结微转移灶的检测的预后价值

目的：通过免疫组化的方法检测非小细胞肺癌患术后常规病理检查阴性的淋巴结的微转移灶，研究其预后价值。方法：用免疫组化角蛋白(CK)染色的方法检测术后常规病理学检查阴性的淋巴结中的微转移灶，以此研究非小细胞肺癌患淋巴结微转移灶的检出和患生存期的关系。结果：在39例患的90枚阴性淋巴结中22例患(56．4％)的26枚淋巴结(28．89％)检出微转移灶。有无复发转移患的淋巴结微转移率有显性差异(81％vs39％，P=0．02)；有无微转移灶的患的生存期各为32个月和48个月，3年生存率各为35％和75％(P=0．0178)。结论：淋巴结微转移灶的检测可以作为非小细胞肺癌患手术后的一个重要的预后指标。

Detection of Micrometastasis in Lymph Nodes of Patients with Non-small-cell Lung Cancer:Its Prognostic Significance

Objective: This study was designed to evaluate the prognostic characteristics of the lymphatic micrometastasis in non-small-cell lung cancer ( NSCLC). Methods: Samples from 90 regional lymph nodes indicated to be tumor free by conventional his-topathologic methods were taken from 39 patients who underwent pulmonary resection for NSCLC, these samples were fixed in formalin and embedded in parafin. CK immunohistochemical staging was used to detect the micrometastic tumor cells in lymph nodes. Results: Micrometastasis were found in 26 lymph nodes (28.89% ) of 22 patients (56.4% ). The survival time of patients with micrometastasis who survived was significantly shorter than that of patients without micrometastasis who survived (32 months vs. 48 months, P = 0. 0178). Conclusion:Immunohistochemical staging for CK offers a rapid, sensitive and useful way of detecting for micrometastasis to the regional lymph nodes in patients with NSCLC. The patients with such micrometastasis have a poor prognosis, and thus need to be carefully followed up after the initial pulmonary resection.