Objective: To explore the effect of advanced gastric cancer on vagniae vasorum of gastric vessels. To provide evidence for the surgical treatment of gastric cancer.
Methods: The study included 107 specimens of left and right gastric arteries (55 left and 52 right ) from 59 patients who underwent radical gastrectomy for carcinoma. All specimens were dealt with frozen section method, then they were stained with HE, enzyme histochemical method and immunohistochemical method, respectively.
Results: Metastatic cancer cells or tubercles were found inside vagina vasorum in some stage IV and III specimens. Cytokeratin positive of tumor cells in or on vagina vasorum was showed on 26 slices from 14 tumors. Among them, 4 slices from 2 tumors belonged to stage III, and 22 slices from 12 tumors belonged to stage IV. Observed under light microscope, the lymphatic capillaries within vagina vasorum were dark brown with 5'-nucleotidase staining in 107 specimens, the capillary tubes within vagina vasorum were blue with alkaline phosphatase staining in 101 specimens. The two structures changed with the development of gastric carcinoma. Average area and bulk density of lymphatic vessel vaginae vasorum were associated with TNM staging of gastric cancer (P=0.001 and P=0.004).
Conclusion: Vaginae vasorum dissection, which may not be applied for early gastric cancer, is recommended when clearing lymph nodes around arteries in radical gastrectomy for carcinomas in stage II and above.