观察傅里叶变换红外光谱技术无创、 原位、 快速诊断胃癌淋巴结转移的可行性。 联合使用衰减全反射探头及傅里叶变换红外光谱仪测量新鲜离体胃周淋巴结红外光谱, 发现每条光谱在吸收波长3 000～1 000 cm-1之间循序出现13条谱带, 依据病理检测结果将淋巴结分为转移组及非转移组, 比较两组淋巴结红外光谱的峰位和相对峰强等指标结果, 最后进行标准统计学分析。 36例胃癌患者, 共检测淋巴结720枚, 其中转移性淋巴结180枚, 未转移540枚; 与非转移淋巴结相比, 转移淋巴结红外光谱有如下特征: (1)与核酸相关的峰强比I1 240/I1 460(p=0.015)和I1 080/I1 460(p=0.034)显著升高, 提示转移淋巴结细胞的核酸含量增多; (2)与蛋白相关的I1 640/I1 460(p=0.001)和I1 546/I1 460(p=0.027)峰强比值升高, 表明转移淋巴结组织的蛋白质含量明显升高; (3)与脂类相关的I2 855/I1 460和 I1 740/I1 460显著降低(p＜0.001), 提示癌组织脂类含量相对减少; (4)I1 160/I1 460(p=0.023)显著降低, 表明恶性细胞糖类物质的减少。 研究结果显示, 傅里叶变换红外光谱分析技术有望成为术中原位、 在体和快速诊断胃癌淋巴结转移的新方法。

To explore the feasibility of quick intraoperative in situ and noninvasive diagnosis of lymph node metastasis in gastric cancer by Fourier transform infrared (FTIR) spectrometry. FTIR spectra of surgically removed fresh lymph nodes were measured by FTIR via probe of attenuated total reflection (ATR). For each spectrum, 13 bands were indentified and assigned between 3 000 and 1 000 cm-1. Peaks in the spectra were measured and relative intensity ratios were calculated and compared between the spectra of Metastatic lymph nodes (MLN) and Non-metastatic lymph nodes(NMLN). Standard statistic analysis was performed. 720 lymph nodes were measured in 38 gastric cancer patients. Results show that there were significant differences between the FTIR of 540 MLN and 180 NMLN. (1) For the band related to nucleic acid: The ratios of I1 240/I1 460(p=0.015) and I1 080/I1 460(p=0.034)increased in MLN, which shows that the relative quantity of nucleic acid was more in MLN than that in NMLN. (2) For the bands related to protein: The ratios of I1 640/I1 460(p=0.001) and I1 546/I1 460(p=0.027) increased in MLN, which shows that the relative quantity of protein was more in MLN. (3) For the bands related to lipid: The ratio of I2 855/I1 460 and I1 740/I1 460 decreased in MLN FTIR spectrum, indicating the lower relative quantity of lipid in MLN. (4) For the bands related to carbohydrate: The ratio of I1 160/I1 460(p=0.023) decreased in MLN FTIR spectrum, indicating the lower relative quantity of carbohydrate in MLN. The results demonstrate that the FTIR spectroscopy technique maybe develop into a promising method for in situ and quick intraoperative differential diagnosis of lymph node metastasis in gastric cancer.