Detection Of Lymph Node Micrometastasis In PNO Gastric Adenocarcinoma And Its Clinical Significance

Objective To determine the lymph node metastasis of patients who undergo surgery with negative lymph node metastasis by immunohistochemical staining and reverse transcription polymerase chain reaction(RT-PCR)with CK20 as the target marker.To explore the two methods of detecting lymph node micrometastasis in gastric cancer and to explore the clinical significance of lymph node micrometastasis in gastric cancer.Methods A total of 32 patients with pNO gastric cancer who underwent radical gastrectomy from January 2013 to June 2016 in Ningxia People's Hospital were selected.A total of 158 lymph nodes were collected and all lymph nodes were detected by HE staining.pathology diagnosis of alll ymph node metastasis was negative.The expression of CK20 in lymph nodes was detected by immunohistochemical staining and RT-PCR.To analyze the relationship between lymph node micrometastasis and sex,age,tumor location,tumor size,depth of invasion,histological type and other clinical pathological parameters of gastric cancer.Results There are 7 patients and 14 lymph nodes were positive of lymph node micrometastasis by immunohistochemically stained.The positive rate of lymph node micrometastasis were 21.87%;A total of 10 patients that were detected by RT-PCR lymph node micrometastasis were positive.The expression of CK20 mRNA in 23 lymph nodes were detected by RT-PCR.Lymph node micrometastasis detection rate was 31.25%.6 patients were positive by both methodss,.There are 4 patients were positive by RT-PCR and negative by immunohistochemistry.1 patient that Immunohistochemical test was positive and negative for RT-PCR.There are 11 patients with gastric cancer lymph node micrometastasis positive.There was significant difference of lymph node micrometastases between different histological types of pNO gastric cancer patients(P <0.05).Lymph node micrometastases in patients with poorly differentiated gastric cancer are more likely to occur than patients with moderate to well-differentiated gastric cancer.Lymph node micrometastases are associated with histological types of gastric cancer patients,regardless of age,sex,tumor location,tumor size,and depth of invasion.Conclusion The lymph node micrometastasis of gastric cancer is related to the histological type of gastric cancer.The patients with poorly differentiated gastric cancer are more likely to undergo micrometastasis than those with moderate to well differentiated gastric cancer.Clinicians to give poorly differentiated gastric cancer patients with reduced surgical treatment should be careful.Immunohistochemistry and RT-PCR combined detection of lymph node micrometastasis in gastric adenocarcinoma have a tendency to improve the detection rate of micrometastasis.