점막하층을 침범한 조기위암 환자에서 림프절의 미세전이와 예후와의 상관관계에 대한 연구
Incidence and Prognostic Implications of Lymph Node Micrometastases in Patients with Submucosal Gastric Cancer
김윤기, 최홍조, 김영훈, 정갑중, 김상순, 홍숙희,
소속 상세정보
김윤기 ( Kim Yoon-Ki )
동아대학교 의과대학 외과학교실
최홍조 ( Choi Hong-Jo )
동아대학교 의과대학 외과학교실
김영훈 ( Kim Young-Hoon )
동아대학교 의과대학 외과학교실
정갑중 ( Jung Ghap-Joong )
동아대학교 의과대학 외과학교실
김상순 ( Kim Sang-Sun )
동아대학교 의과대학 외과학교실
홍숙희 ( Hong Sook-Hee )
동아대학교 의과대학 병리학교실
KMID : 0371320010610020158
Abstract
Purpose
Whereas lymph node metastasis in gastric cancer is an important prognostic factor, the prognostic relevance of occult tumor cells in lymph nodes has not yet been elucidated. The aims of this study were to assess the incidence of micrometastases
of
lymph
nodes in patients with submucosally invaded gastric cancer and to investigate whether micrometastases of lymph nodes have prognostic significance.
Methods
In order to evaluate the incidence of lymph node micrometastases in patients with submucosal gastric cancer, 1423 lymph nodes taken from 55 patients were assessed by immunohistochemical technique using a monoclonal anti- human cytokeratin-8.
Clinicopathologic parameters and prognoses were compared between patients with and without micrometastases.
Results
The incidence of nodal involvement by tumor cells in 55 patients with submucosal gastric cancer increased from 20.0% (11 patients) by hematoxylin-eosin (H-E) staining to 30.8% (17 patients) by immunohistochemical staining. Nodal positivity in
this
study
increased from 0.8% (12/1423 nodes) by H-E staining to 3.2% (45/1423 nodes) by immunohistochemical staining (p=0.003). The presence of cytokeratin positivity was not related to various clinicopathologic factors. As estimated by the Kaplan-Meier
lifetable methods, there was no significant difference in the five-year survival rate between the micrometastases negative and positive groups (94.8%and 94.1%, respectively).
Conclusion
The presence of nodal micrometastases detected by immunohistochemical technique is an interesting phenomenon, however clinically it seems to be of only weak prognostic value in submucosal gastric cancer.
키워드
미세전이; Cytokeratin; 위암; 점막하층; Micrometastasis; Cytokeratin; Gastric cancer; Submucosal layer;
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