Detection And Clinical Significance Of Lymph Node Micrometastases In Patients With Histologically Node-Negative Gastric Cancer

Objective To study micrometastasis in lymph node from patients with node-negative gastric cancer according to routine histologic examination and its relevance to clinicopathological parameters and prognosis.Methods Immunohistochemical method was adopted to detect Cytokeratin(AE1/AE3) ,ESA and Telomerase in 307 perigastric lymph nodes histologically free of metastasis from 43 cases of gastric cancer.Results Micrometastases were observed in 31 lymph nodes(10%) of 10 patients(23.8%).The incidence of lymph node micrometastasis was significantly higher in the diffuse type than that in the intestinal type of gastric cancer.The presence of micrometastases was closely correlated with invasion depth of primary tumor,but was not correlated with age,sex,size and location of the primary tumor.The 5-years survival of patients with micrometastases in their resected lymph nodes was significantly lower than that of patients without micrometastases.Conclusion It is necessary to detect lymph node micrometastases, because it can more accurately determine the clinical staging,direct cancer therapy and predict prognosis in patients with node-negative gastric cancer by routine histological examination.