ABSTRACT
<p><b>OBJECTIVE</b>To investigate the evaluation of lymphatic emboli by D2-40/CKpan dual immunostain and its prognostic significance in advanced primary gastric adenocarcinoma.</p><p><b>METHODS</b>Tissue samples of 108 cases of advanced gastric adenocarcinoma with radical gastrectomy were collected from Chinese PLA General Hospital in 2001. Lymphatic emboli were evaluated by D2-40/CKpan dual immunostain on consecutive sections, and compared with routine HE staining. The correlation of lymphatic emboli with lymph node metastasis and overall survival was analyzed by Pearson Chi-squared test and univariate survival analysis, respectively.</p><p><b>RESULTS</b>Lymphatic emboli were detected in 73/108 (67.6%) cases by D2-40/CKpan staining, compared to 57/108 (52.8%) by HE staining. There was significant difference (P=0.007). Lymphatic emboli on HE staining revealed false negative in 24/108 cases and false positive in 8/108 cases. A significant correlation was found between lymphatic emboli and lymph node metastasis on HE staining (P=0.024), while it was not found on D2-40/CKpan staining (P=0.422). The overall survival rate was significantly different between lymphatic emboli positive and negative cases on HE staining (P=0.043). The overall survival rate was lower in lymphatic emboli positive cases on HE staining. Lymphatic emboli evaluated on D2-40/CKpan staining had no prognostic value (P=0.402).</p><p><b>CONCLUSION</b>D2-40/Ckpan dual immunostaining is more sensitive for lymphatic emboli in gastric adenocarcinoma but may not predict lymph node metastasis and survival, while HE staining may.</p>