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目的分析早期胃癌的组织学类型和淋巴结微转移及诊断体会。方法对80例早期胃癌的手术标本进行石蜡切片苏木素伊红染色。胃癌组织和淋巴结进行免疫组化检测,包括细胞角蛋白(CK)、上皮膜抗原(EMA)和癌胚抗原(CEA)。结果 80例早期胃癌中肠型有22例,弥漫型有35例,混合型有23例。位于粘膜内有62例,浸润至粘膜下层有18例。伴局部淋巴结转移有8例,均为弥漫型或混合型胃癌的微小转移。结论纤维胃镜的广泛应用,使弥漫型早期胃癌的检出率提高,弥漫型早期胃癌更容易发生淋巴结的微小转移,免疫组化有助于淋巴结微小转移的诊断。
Objective To analyze histological types and lymph node micrometastases and their diagnosis in early gastric cancer. Methods 80 cases of early gastric cancer specimens were paraffin-embedded hematoxylin-eosin staining. Gastric cancer tissues and lymph nodes were examined by immunohistochemistry, including cytokeratin (CK), epithelial membrane antigen (EMA) and carcinoembryonic antigen (CEA). Results There were 22 cases of midgut type in 80 cases of early gastric cancer, 35 cases of diffuse type and 23 cases of mixed type. 62 cases located in the mucosa, infiltration into the submucosa in 18 cases. There are eight cases with local lymph node metastasis, all diffuse or mixed gastric cancer micrometastasis. Conclusion The wide application of fiber gastroscopy makes the detection rate of diffuse early gastric cancer increased, lymph node micrometastasis is more likely to occur in diffuse early gastric cancer, and immunohistochemistry is helpful for the diagnosis of lymph node micrometastasis.