| Objective It has been identified by considerable clinical studiesand experiments that lymph node metastasis is a main and prevalent pathway of metastasis in the gastric cancer and lymph node metastas is one of the most important factor influencing the life span of the patients with gastric cancer . The purpose of this study is to determine the expression feature of Galectin-3 and the rule of lymph node micrometastasis in the early gastric cancer. By analyzing the relationship of the expression of Galectin-3 and lymph node micrometastasis in the early gastric cancer, we want to find predicting markers for lymph node micrometastasis in the early gastric cancer and provide evidence for how to select the surgical procedures for the early gastric cancer.Methods From February 1999 to February 2005, the clinical data of56 patients with early gastric cancer from the Department of General Surgery of the People's Hospital of Liaocheng city were retrospectively ana lyzed. All cases were operated by radical gastrectomy associated with D2 lymph node dissection, 10 patients with early gastric cancer were clearly diagnosed preoperatively, the others were venified by postoperative pathologic examination. Of the 56 cases, the expression of Galectin-3 in the early gastric cancer tissue and its adjacent normal tissue. All lymph nodes were detected, 120 lymph nodes were consecutively cut into serial sections and examined by micr- oscope and detected the negative lymph nodes by HE staining with Mono clonal Mouse Anti-cytokeratin( AE1/AE3).All data were analyzed by SPSS 11. 5, using X2-test and t-test, a p-value was less than 0.05 was considered to be statistically significant.Results (1) This data showed that the clinical diagnostic accuracy of early gastric cancer was 17.86%. (2) Among 56 early gastric cancer patients, tumor metastasis was found in one lymph node of one patient by routine HE staining. Micrometastasis was found in 13 lymph nodes of seven patients with primary gastric cancer by AE1/AE3 staining, the positive rate of micrometastasis was 12. 50% (7/56), the positive rate of lymph node metastasis was 11. 67% (14/120). The positive rate of lymph node metastasis was elevated from 0. 83% (1/120) by HE staining to 11. 67% (14/120) by AE1/AE3 staining. Among 55 early gastric cancer pa- tients without lymph node metastasis by routine HE staining, the positive rate of lymph node micrometastasis was 10. 91% (6/55). (3) The positive rate of lymph node metastasis of submucosal carcinoma was manifestly higher than intramucosal carcinoma (26. 92% vs 0%, P<0.01) . (4) Galectin-3 resides in cytoplasm mainly , and it may also resides in cell nucleus, cell membrane . The expression of Galectin-3 in the normal tissue was faint,it was highly expressed in the well differentiated , moderatedly differentiated , poorly diff-erentiated, un- differentiated gastric cancer tissue. The distinction of the expression of Galectin-3 between well differentiated and moderatedly differentiated gastric cancer tissue had no-significance , the distinction of the expression of Galectin-3 between poorly differentiated and un- differentiated gastric cancer tissue had no-significance (P>0. 05), The distinction of the expression of Galectin-3 between poorly differentiated and moderatedly differentiated gastric cancer tissue had significance (P<0.05) .The degree of enhanced of immunological reaction of Galectin-3 was related to various his- topathological subtypes in early gastric cancer tissue, which was en- hanced along with degrade of differentiated degree of the early gastric cancer tissue and which was more frequently observed in patients with lymph node metastasis.Conclusion (1) AE1/AE3 immunohistochemical method may exactlydetect lymph node micrometastasis in the patients with early gastric cancer. (2) Using univariate analysis, depth of invasion and histological type showed a significant effect on lymph node metastasis. (3) The present results suggested that the patients with increased expression of Galectin-3 without lymph nodes metastasis have strong tendency of lymph nodes metastasis, even lymph node micrometastasis had already occurred. The expression of Galectin-3 revealed important significance for the prongostic evaluation and treatment of the early gastric cancer patients . (4) Endoscopic mucosal resection and other limitied operation is inappropriate for the patients with enhanced expression of Galectin-3, D2 radical gastrectomy is a standard procedure for these patients. |
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