Inferior Part Of Cancer Conventional Pathological Negative No.1, No.9 And No.14v Group Of Lymph Node Micro-metastasis

Objective:To evaluate the status of lymph node micrometastasis of "non-metastatic" No.1,No.9 and No.14v group lymph nodes as judged by conventional pathology in the lower third of gastric cancer,then analyze the relationships between clinical characteristics and lymph node micrometastasis.Method:Consecutive section and Telomeric repeat amplication protocol(TRAP)—enzyme linked immunosorbent assay(ELISA) were applied in detecting micrometastasis of 53 patients' No.1,No.9 and No.14v group lymph nodes(No.1 group 45 cases,No.9 group 41 cases and No.14v group 44 cases),the data was analyzed by statistical method.Results:Micrometastasis were discovered in 4 cases'6 lymph nodes of 66 No.1 group lymph nodes,3 cases'4 lymph nodes of 82 No.9 group lymph nodes and 2 cases'4 lymph nodes of 85 No.14v group lymph nodes by consecutive sections,while using TRAP-ELISA, micrometastasis were detected in all the "posetive" lymph nodes by consecutive sections,further more,another 7 cases' 10 lymph nodes of No.1 group,8 cases' 13 lymph nodes of No.9 group and 11 cases'11 lymph nodes of No.14v group were diagnosed as "metastasised".The micrometastasis rate of No.1,No.9 and No.14v group lymph nodes were 24.44%(4+7/45),26.83%(3+8/41),29.55%(2+11/44) respectively.The micrometastasis ratio of the three group lymph nodes were:No.1 group 24.24% (6+10/66),No.9 group 20.73%(4+13/82) and No.14v group 17.65%(4+11/85).The difference between consecutive section and TRAP-ELISA has statistical significance (χ₁²=5.1429,χ₉²=6.1250,χ_14v²=9.0909,P＜0.05).Clinical characteristics such as age,gender and histological types have no statistical significance(P＞0.05 ),whereas Borrmann types,invasion depth,tumor diameter and TNM staging have statistical significance(P＜0.05).Conclusion:TRAP-ELISA is more sensitive than consecutive sections,No.1,No.9 and No.14v group lymph nodes in gastric cancer of the lower third show a high rate of micrometastasis.For a better staging and precise indication,micrometastasis should be detected for those "non-metastatic" lymph nodes,D2 resection is the standard procedure.