食管胃结合部腺癌肿瘤出芽预测淋巴结转移的价值

目的探讨食管胃结合部腺癌肿瘤出芽预测淋巴结转移的价值。方法选择我院1989年1月～2010年12月行根治性切除手术的食管胃结合部腺癌119例，全数检查手术标本中的淋巴结，参照Ueno等的方法判断肿瘤出芽；分析肿瘤出芽的相关因素，计算肿瘤出芽预测淋巴结转移的敏感性、特异性和准确度，以及阳性预测值和阴性预测值。结果本组119例手术标本共检出淋巴结6537枚（30～157枚），平均（54．93±19．20）枚／例。119例中96例发现肿瘤出芽，出芽率为80．67％。肿瘤出芽与肿瘤部位、pT分期、pN分期和Laur6n分型明显相关。肿瘤出芽预测淋巴结转移的敏感性为97．75％，特异性为70．00％，准确度为90．76％；阳性预测值为90．63％，阴性预测值为91．30％。结论肿瘤出芽可以准确预测食管胃结合部腺癌的淋巴结转移状况。

Prognostic Value of Tumor Budding to Predict Lymph Node Metastasis in Adenocarcinomas of the Esophagogastric Junction

Objective To discuss the value of tumor budding to predict lymph node metastasis in adenocarcinomas of the esophagogastric junction. Methods The clinicopathological data of 119 patients with aden the esophagogastric junction who underwent radical surgery in our hospital from January 1989 to December 2010 were retrospectively analyzed. All lymph nodes collected from these specimens were examined. Tumor budding was identified according to the method mentioned by Ueno and his colleagues. The correlative factors of tumor budding were ana- lyzed. The sensitivity, specificity, accuracy, positive predict value and negative predict value of using tumor budding to predict lymph node metastasis were calculated. Results A total of 6537 （30 - 157 ） lymph nodes were detected form the surgical specimens of 119 patients with adenocarcinomas of the esophagogastric junction,and the average number of detected lymph nodes was 54.93 ± 19.20. Tumor budding were detected in 96 patients with adenocarcinomas of the esophagogastric junction. Significant correlation was found between tumor budding and the tumor site, pT staging, pN staging ang Laur6n types. The sensitivity, specificity, accuracy, positive predict value and negative predict value of using tumor budding to predict lymph node metastasis were 97.75% ,70.00% ,90.76% ,90.63% and 91.30%, respectively. Conclusion Lymph node metastasis can be predicted by tumor budding identified by H. E staining in adenocarcinomas of the esophagogastric junction.