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目的探讨右半结肠外科干淋巴结清除的临床意义。方法对进展期右半结肠癌32例患者行外科干淋巴结清扫,并将所得淋巴结行常规病理染色检测及癌胚抗原(CEA)、上皮抗原(EMA)免疫组织化学(免疫组化)微转移检测。结果常规病理外科干淋巴结转移率9.4%(3/32)。CEA、EMA表达阳性率分别为31.2%(10/32)及37.5%(12/32),CEA和EMA联合检测阳性率46.9%(15/32)。DukesB、C期结肠癌淋巴结微转移率分别为29.4%(5/17)及66.7%(10/15),两者比较差异有统计学意义(P<0.05)。结论对进展期右半结肠癌外科干淋巴结行CEA、EMA免疫组化微转移检测,有利于更精确地了解淋巴结转移范围。
Objective To investigate the clinical significance of surgical treatment of right and left colon lymph nodes. Methods Thirty-two patients with advanced right colon cancer were treated by surgical lymphadenectomy. The lymph nodes were examined by routine histopathology and CEA and EMA immunohistochemical staining . Results The rate of lymph node metastasis in routine pathology was 9.4% (3/32). The positive rates of CEA and EMA were 31.2% (10/32) and 37.5% (12/32), respectively. The positive rate of CEA and EMA was 46.9% (15/32). The rates of lymph node micrometastases in DukesB and C colon cancer were 29.4% (5/17) and 66.7% (10/15), respectively, with significant difference between the two groups (P <0.05). Conclusion The immunohistochemical micrometastasis detection of CEA and EMA in patients with advanced right colon cancer has the advantage of more accurate understanding of the range of lymph node metastasis.