Abstract
We have investigated the relation between the grade of lymph ducts infiltration in primary lesion and the spread of lymph node metastasis in 236 cases of gastric cancer. This study suggested that lymph node metastasis established at more distal lymph nodes with an increase in the grade of lymph ducts infiltration. The cases exhibiting the same grade of lymph ducts infiltration were classified into proximal lymph nodes metastasis group (group 2) and distal lymph nodes metastasis group (group 3). There were no differences in histologic features of primary lesion between both groups, but poorly differentiated adenocarcinoma was more frequently found in group 3 than group 2. On the other hand an analysis of metastatic regional lymph flow cytometry suggested that natural killer cell ratio increased. So the relation between natural killer cell ratio in the proximal metastatic lymph nodes and the spread of lymph node metastasis was studied in 21 cases of gastric cancer, 8 cases belonged group 2 and 13 cases belonged to group 3. In this study, the NK index which is %(Leu7-CD16+)×3+%(Leu7+CD16+)×2+%(Leu7+CD16-)×1 was employed. The NK index was 42.1±24.3 in group 2 versus 7.3±5.O in group 3 (p<0.01). It is suggested that in gastric cancer the spread of lymph nodes metastasis may depend on some factors including the histrogical type of carcinoma and response of natural killer cells in the regional lymph nodes.
