共查询到20条相似文献,搜索用时 156 毫秒
1.
采用RT-PCR技术检测52例食管癌患者术前外周血液及术后病理诊断阴性的212枚区域淋巴结(pN0)中癌胚抗原(CEA)mRNA的表达.发现15例患者的术前血液中检测到CEA mRNA表达.17例患者的24枚淋巴结检测到CEA mRNA表达.CEA mRNA表达与肿瘤分化程度及浸润深度显著相关(P<0.05).血液及淋巴结微转移者3 a生存率均明显低于无微转移者(P均<0.05).多因素回归分析结果显示,肿瘤浸润深度、血液微转移及淋巴结微转移是独立的预后因素(P均<0.05).认为微转移与食管癌术后早期复发转移及预后不良有关,检测食管癌术前血液及术后病理诊断阴性的pN0中CEA mRNA表达,可以诊断食管癌微转移. 相似文献
2.
3.
4.
5.
6.
目的探讨食管癌淋巴结转移的危险因素。
方法回顾性分析2015年7月至2017年9月,新疆自治区人民医院胸外科行手术治疗食管癌的224例患者的病例资料,比较淋巴结转移组(转移组)与非淋巴结转移组(非转移组)的关系,并进行多因素Logistic回归进行分析,探讨淋巴结转移的危险因素。
结果患者症状期较长、肿瘤长度、分化程度、肿瘤分期T与淋巴结转移有显著相关性(P<0.05)。
结论肿瘤低分化、肿瘤长度>5 cm、肿瘤侵润深度T3~T4、患者症状期>6个月是淋巴结转移的危险因素,应尽可能选择经右胸入路胸腹腔镜辅助下食管癌根治术,并清扫双侧喉返神经淋巴结。 相似文献
7.
目的观察常规病理学检查无淋巴结转移的贲门癌淋巴结的微转移情况,并探讨其临床意义。方法采用免疫组化SP法,用细胞角蛋白19(CK19)单抗和CD44v6单抗检测48例贲门癌患者常规病理学检查阴性的323枚淋巴结的微转移情况。结果本组9例14枚淋巴结发现微转移。淋巴结微转移与贲门癌患者年龄、性别及肿瘤直径、浸润深度、分化程度无关(P均〉0.05),与贲门癌的Lauren分型有关(P〈0.05)。45例随访患者中,有淋巴结微转移者3、5年生存率明显低于无淋巴结微转移者(P均〈0.01)。结论常规病理学检查无淋巴结转移的贲门癌患者淋巴结常存在微转移;淋巴结微转移的检测有助于贲门癌患者的预后判断。 相似文献
8.
评价早期胃癌预后最主要指标是有无淋巴结转移和肿瘤浸润深度。早期胃癌淋巴结微转移的研究大大提高了诊断胃癌淋巴结转移的准确性,使得该疾病的临床病理分期及其预后的评价更具科学性,对确定手术方案及综合治疗有重要意义。 相似文献
9.
10.
评价早期胃癌预后最主要指标是有无淋巴结转移和肿瘤浸润深度。早期胃癌淋巴结微转移的研究大大提高了诊断胃癌淋巴结转移的准确性,使得该疾病的临床病理分期及其预后的评价更具科学性,对确定手术方案及综合治疗有重要意义。 相似文献
11.
Swati H. Shah Nikhil Gupta Gurudutt Gupta Anurag Mehta Shivendra Singh 《Indian journal of gastroenterology》2017,36(4):268-274
Background
Prognosis of gallbladder cancer (GBC) is grim even after curative surgery. Lymph node metastasis is the most important prognostic factor, but distant relapses occurring in their absence point towards additional factor. Lymph node micrometastasis could be one. The present study aimed to evaluate the incidence and clinical significance of lymph node micrometastasis.Methods
This is a prospective study of patients undergoing curative surgery for GBC from 1 March 2013 to 30 April 2015, at our institute. All lymph nodes were examined with hematoxylin and eosin and immunohistochemistry against CK7. The incidence of lymph node and its relation to other clinicopathological parameters, recurrence, and survival was evaluated.Results
Out of 589 lymph nodes retrieved from 40 patients, metastasis was seen in 13 (2.20%) nodes from 8 (20%) patients and micrometastasis in 4 (0.68%) nodes from 3 (7.5%) patients. Micrometastases were absent in pT1 tumors (0/10 in pT1 vs. 3/30 in pT2–4) and more common in patients with nodal metastasis (13% vs. 6%). Though the presence of micrometastasis would have upstaged the disease, it did not statistically relate to clinicopathological parameters, recurrence, and survival.Conclusions
Incidence of lymph node micrometastasis in GBC was low and did not correlate with other clinicopathological parameters, recurrence, and survival.12.
Hitoshi Shiozaki Yoshiyuki Fujiwara Toshihiro Hirai Hisahiro Matsubara Masaki Mori Tsutomu Nakamura Yukihiro Nakanishi Shoji Natsugoe Tsuyoshi Noguchi Soji Ozawa Yutaka Shimada Seiji Udagawa Hideaki Yamana Masahiko Yano Takushi Yasuda Akio Yanagisawa 《Esophagus》2007,4(1):35-39
Background In esophageal carcinoma, the clinical significance of immunohistochemically (IHC)-detected lymph node (LN) micrometastasis
is still controversial. We designed this multicenter study to determine the clinical significance of IHC-detected LN micrometastasis
in esophageal carcinoma.
Methods The subjects were 164 patients with histopathologically confirmed LN-negative esophageal carcinoma from eight hospitals. A
similar IHC technique was used in all institutions, and micrometastasis was diagnosed by a researcher at each hospital as
well as independently by pathologists with special interest in esophageal carcinoma.
Results IHC-related micrometastasis in LN was considered positive in 51 (31%) patients by the researchers and in 25 (15%) by the pathologists.
The latter micrometastases were further classified into a single (n = 13) and clusters (n = 12) of immunopositive-LN. Kaplan–Meier analysis showed that researcher-based diagnosis of micrometastasis had no significant
impact on prognosis whereas the cluster-type micrometastasis diagnosed by pathologists had a significant impact on prognosis.
Conclusions We speculate that the inconsistent results of IHC analyses reported in the literature are caused by the use of different definitions
of micrometastasis and the subjective nature of diagnosis of micrometastasis, i.e., dependence on the examiner. Our multiinstitutional
study also indicates that the morphological aspects of immunostained cells should be considered when assessing micrometastasis
in LN by IHC and that only LN with clusters of IHC-positive cells are prognostically significant in esophageal carcinoma. 相似文献
13.
Perez RO Habr-Gama A Nishida Arazawa ST Rawet V Coelho Siqueira SA Kiss DR Gama-Rodrigues JJ 《International journal of colorectal disease》2005,20(5):434-439
Objective The objective was to determine the presence and frequency of micrometastasis in lymph nodes of patients with rectal cancer treated by preoperative chemoradiation followed by curative resection.Patients and methods All 56 patients included were treated with 5-FU and leucovorin plus 5,040 cGy, followed by radical surgery and were diagnosed with stage II distal rectal adenocarcinoma after complete pathological examination (ypT3-4N0M0). Immunohistochemistry was assessed with cytokeratin monoclonal antibody AE1/AE3. Three 4-m paraffin sections were obtained from each lymph node, cut at 50 m apart from each other. The results were reviewed by two independent pathologists.Results Mean number of lymph nodes was 9.6 per patient. Four patients (7%) and seven lymph nodes (1.35%) were positive for micrometastasis. Three patients had pT3 and one a pT4 tumor. One of the patients had positive micrometastasis and the presence of mucinous deposits. One other patient had mucinous deposits without any micrometastasis. All four patients are alive with no evidence of recurrent disease. Fourteen patients negative for micrometastasis had recurrent disease (25%), eight systemic (14.7%) and six locoregional (10.3%). There were two cancer-related deaths. The mean follow-up period was 39 months.Conclusion Patients with rectal cancer treated by preoperative chemoradiation showed a surprisingly low rate of micrometastasis detection (7%), even in high-risk patients (T3 and T4 tumors). Lymph node micrometastasis was not associated with decreased overall or disease-free survival. The identification of mucinous deposits on lymph nodes with no viable tumor cells may be direct evidence of lymph node downstaging. The downstaging effect of preoperative chemoradiation therapy may be significant in reducing even micrometastasis detection in low rectal cancer managed by this treatment strategy. 相似文献
14.
15.
16.
《Scandinavian journal of gastroenterology》2013,48(7-8):881-886
Abstract Objective. Although patients with Stage I colorectal cancer show an excellent prognosis, a few of them die of metastatic disease. In this subgroup of individuals, the search of occult metastasis might reveal that early dissemination of tumor cells could be the cause of cancer progression. Material and methods. Through a Cancer Registry, we selected all patients with Stage I disease who died of metastatic tumor; a total of 32 patients were identified and in 25 of them paraffin-embedded material was available. The group was matched to 70 Stage I patients with favorable prognosis (controls). In cases and controls resected lymph nodes were cut, and micrometastases were searched using pan-cytokeratin antibodies. Results. Micrometastases were detected in 18 of 25 (72%) Stage I patients who died of the disease, while they were almost absent among controls (1 of 70, p < 0.001 by χ2 test). Vascular invasion and tumor budding were more frequent among Stage I patients with an unfavorable prognosis than in controls. By regression analyses, micrometastases (HR 12.3, CI 4.8–32) and vascular invasion (HR 3.5, CI 1.4–8.5) maintained an independent association with prognosis (cancer-specific survival). Conclusion. Micrometastasis in the lymph nodes can be revealed in the majority of patients with early colorectal cancer who die of tumor progression, while they appear extremely rare in Stage I individuals with good prognosis. The selection of patients through histology (vascular invasion) and search of occult metastatic cells might represent a way to identify individuals who might benefit from adjuvant chemotherapy. 相似文献
17.
18.
19.
Masayuki Sho Yoshiaki Murakami Fuyuhiko Motoi Sohei Satoi Ippei Matsumoto Manabu Kawai Goro Honda Kenichiro Uemura Hiroaki Yanagimoto Masanao Kurata Takumi Fukumoto Takahiro Akahori Shoichi Kinoshita Minako Nagai Satoshi Nishiwada Michiaki Unno Hiroki Yamaue Yoshiyuki Nakajima 《Journal of gastroenterology》2015,50(6):694-702