Journal of Gastric Cancer

  • 제2권1호
  • /
  • Pages.5-11
  • /
  • 2002
  • /
  • 2093-582X(pISSN)
  • /
  • 2093-5641(eISSN)
대한위암학회 (The Korean Gastric Cancer Association)
권호 표지

위암에서 림프절 미세전이의 면역조직화학적 방법에 의한 측정 및 생존율과의 상관관계

Immunohistochemical Assay for Lymph-Node Micrometastasis in Gastric Cancer and Correlation with Survival Rate

  • 문철 (순천향대학교 의과대학 외과학교실) ;
  • 박경규 (순천향대학교 의과대학 외과학교실) ;
  • 이문수 (순천향대학교 의과대학 외과학교실) ;
  • 허경열 (순천향대학교 의과대학 외과학교실) ;
  • 장용석 (순천향대학교 의과대학 외과학교실) ;
  • 김재준 (순천향대학교 의과대학 외과학교실) ;
  • 이민혁 (순천향대학교 의과대학 외과학교실) ;
  • 진소영 (순천향대학교 의과대학 외과학교실 및 임상병리학교실) ;
  • 이동화 (순천향대학교 의과대학 외과학교실 및 임상병리학교실)
  • Moon Chul (Departments of Surgery College of Medicine, Soonchunhyang University) ;
  • Park Kyung-Kyu (Departments of Surgery College of Medicine, Soonchunhyang University) ;
  • Lee Moon Soo (Departments of Surgery College of Medicine, Soonchunhyang University) ;
  • Hur Kyung Yul (Departments of Surgery College of Medicine, Soonchunhyang University) ;
  • Jang Yong Seog (Departments of Surgery College of Medicine, Soonchunhyang University) ;
  • Kim Jae Joon (Departments of Surgery College of Medicine, Soonchunhyang University) ;
  • Lee Min Hyuk (Departments of Surgery College of Medicine, Soonchunhyang University) ;
  • Jin So-Young (Departments of Anatomic Pathology, College of Medicine, Soonchunhyang University) ;
  • Lee Dong Wha (Departments of Anatomic Pathology, College of Medicine, Soonchunhyang University)
  • 발행 : 2002.03.01
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초록

Purpose: The purpose of this study is to identify immunohistochemical evidence of lymph-node micrometastasis in histologic node-negative gastric cancer patients and to evaluate the prognostic significance of lymph-node micrometastasis.Materials and Methods: A retrospective study of 50 gastric cancer patients who underwent curative resections from October 1990 to November 1994 was performed. Two consecutive sections were prepared: one for ordinary hematoxylin and eosin staining, and the other for immunohistochemical staining with Pan cytokeratin antibody (Novocastra, UK). In the univariate analysis, the survival rate was calculated using the Life Table Method, and the multivariate analysis was determined using a Cox Proportional HazardsModel. The statistical analyses of the relationships between the clinicopathologic factors and micrometastases were performed by using a Chi-square test. Results: Of 2522 harvested lymph nodes, 81 ($4.1\%$) nodes and 19 ($38\%$) of 50 patients were identified as having lymphnode micrometastases by using immunohistochemical staining for cytokeratin. The incidence of lymph-node micrometastases was significantly higher in diffuse type carcinomas ($54\%$, P=0.024) and in patients with serosal invasion ($52.2\%$, P=0.05). For patients with lymph-node micrometastases (n=19), the 5-year survival rate was significantly decreased ($73.7\%$, P=0.015). The Lauren's classirication (P=0.021) and the depth of invasion (P=0.035) were shown by multivariate analysis to have a significant relationship with the presence of micrometastases. Multivariate analysis revealed that lymph-node micrometastasis was independently correlated with survival in histologic node-negative gastic cancer patients. Conclusion: The presence of cytokeratin detected lymphnode micrometastases correlates with the worse prognosis for patients with histologic node-negative gastric cancer.

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