| ObjectiveThe incidence of gastric cancer which is one of the most common malignant tumors,was decreased in some countries in recent years, but in China, besides lung cancer, it is stillone of the most common malignant tumors and ranks first in the digestive system. Themain cause of death is metastasis and recurrence of gastric cancer. Lymph node metastasisis the most common and important metastasis pathway in gastric cancer. It is also one ofthe most important factors which influence the prognosis and survival of patients. AccuratePN staging can timely guide the application of adjuvant chemotherapy for gastric cancerafter operation. The reliability of PN stage is affected not only by the cleaning number ofmetastatic lymph nodes, but also by the number of slices of each lymph node. Because ofthe large number of lymph node dissection during the radical D2gastric cancer, thefabrication of pathological slices is a workload, time-consuming and expensive work. As aresult, we should wait for a long time to get the results which may affect the treatmentimmediately. Detection rates of lymph node metastasis through routine HE staining isbelow20%. This method may also ignore the presence of micro-metastasis, which willdirectly influence the accuracy of PN staging of gastric cancer after operation. Therefore, asimple, rapid and accurate method which may judge PN stage after the operation of gastriccancer is needed. In this experiment, we detect the content of CEA in lymph node throughthe electro-optic chemical detection in order to explore the relationship between extractcontent of CEA with lymph node metastasis. This research may contribute to theimmediate PN staging after operation and timely application of adjuvant chemotherapy.MethodsPatients who underwent the radical operation of gastric cancer from2012April to 2013April were included in this experiment. We use the electro-optic chemical detection todetect the CEA content in leaching solution of lymph node and we also use routine HEstaining of lymph nodes for pathological examination. The immunohistochemistry wasused to detect the micro-metastasis in lymph node which presents negative through routineHE staining, The serum CEA levels were both detected preoparation and postoperation.The experimental results were statistically analyzed with routine HE staining, pathologicalexamination, immunohistochemical examination, and preoperative, postoperative serumCEA content in order to explore the relationship of these three methods. By analyzing thepostoperative CEA level and the number of positive lymph nodes cleaned during surgery,we aim to further illustrate the importance of cleaning lymph node in patients sufferedgastric cancer.ResultsAccording to the method which was used to detect the CEA content in leachingsolution of lymph node in Liu Wen’s research,50ng/mg was defined as the threshold (≥50ng/mg as positive, negative <50ng/mg). The results in the electro-optic chemical methodhas a higher specificity than that in the conventional HE staining(p<0.05). However, thereis no statistical difference between the results of the two methods about sensitivity(p>0.05).There is also no statistical difference between the results in electro-optic chemical andimmunohistochemistry method. By comparing the results by linear regression analysis,there is statistical significance between the serum CEA levels after surgery with thecleaning of positive lymph nodes (p<0.05). As a result, our research have furtherdemonstrated the importance of gastric lymph node dissection.ConclusionCEA has a higher expression in leaching solution of metastatic lymph nodes than thatin the normal lymph nodes. Compared with the conventional HE staining method,electro-optic chemical method is simple, fast, and accurate, which could be used to guidePN stage and application of auxiliary treatment after operation. It is also useful to makeadjuvant treatment plan and inform the patients prognosis. |
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