D2-40标记食管鳞癌淋巴管浸润的检测及其临床病理意义

  目的   探讨D2-40标记食管鳞癌淋巴管浸润(LVI)的临床病理意义。   方法   应用免疫组织化学S-P法检测107例食管鳞癌D2-40蛋白表达并观察淋巴管受肿瘤细胞浸润的情况, 分析其与食管鳞癌临床病理因素之间的关系, 观察患者总生存期。   结果   食管鳞癌组织LVI阳性组淋巴结转移率70%, LVI阴性组淋巴结转移率21%, LVI阳性组转移率高于阴性组, 多因素分析显示两组间差异有统计学意义(P < 0.001)。LVI阳性组中位生存时间为26个月, LVI阴性组中位生存时间43个月, 单因素分析显示两组间差异有统计学意义(P=0.014), 多因素分析显示LVI不能成为食管鳞癌术后患者预后的独立危险因素(P=0.062), 淋巴转移(P=0.031)、临床分期(P=0.019)和肿瘤残留(P=0.026)是预后的独立危险因素。   结论   D2-40标记的LVI可以预测食管鳞癌患者的淋巴结转移。 

Detection of D2-40 monoclonal antibody-labeled lymphatic vessel invasion in esophageal squamous cell carcinoma and its clinicopathologic significance

  Objective   This study aims to investigate the clinicopathological significance of lymphatic vessel invasion(LVI) labeled by D2-40 monoclonal antibody in esophageal squamous cell carcinoma(ESCC).   Methods   Immunohistochemical assay was used to detect the expression of D2-40 and LVI in 107 ESCC cases.Then, the correlation between the clinicopathological feature and the overall survival time in patients was analyzed.   Results   The lymph node metastasis rates were 70% and 21% in the LVI-positive and LVI-negative groups, respectively.The nodal metastasis rate was higher in the LVI-positive group than in the LVI-negative group.Multivariate regression analyses showed that LVI was related to nodal metastasis(P < 0.001).The median survival times of the patients were 26 and 43 months in the LVI-positive and LVI-negative groups, respectively.Although the univariate regression analysis showed significant difference between the two groups(P=0.014), the multivariate regression analyses revealed that LVI was not an independent prognostic factor for overall survival in the ESCC patients(P=0.062).Lymphatic node metastasis(P=0.031), clinical stage(P=0.019), and residual tumor(P=0.026) were the independent prognostic factors.   Conclusion   LVI labeled by D2-40 monoclonal antibody is a risk factor predictive of lymph node metastasis in ESCC patients.