细胞角蛋白20、基质金属蛋白酶-7诊断结直肠癌淋巴结微转移的临床意义  

Clinical significance of CK20 and MMP-7 in diagnosing lymph node micrometastasis in colorectal cancer

作　　者：孙帅[1] 王锡山[2] 

机构地区：[1]解放军第211医院普通外科,哈尔滨150080 [2]哈尔滨医科大学附属肿瘤医院结直肠外科

出　　处：《中华临床医师杂志（电子版）》2011年第18期5294-5298,共5页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的利用细胞角蛋白20(CK20)、基质金属蛋白酶-7(MMP-7)检测结直肠癌淋巴结微转移,探索其与临床病理因素及预后的关系,指导临床治疗。方法收集1999年1～12月行结直肠癌根治术的94例患者切除的全部淋巴结,以常规HE染色法及CK20、MMP-7抗体免疫组织化学染色方法检测淋巴结微转移,并对全部患者进行随访。结果 (1)检出淋巴结微转移患者32例(34.04%,32/94);检出微转移淋巴结35枚(9.64%,35/363)。(2)DukesA、B期与DukesC期微转移的发生率差异有统计学意义。(3)结直肠癌淋巴结微转移仅与肿瘤的分化程度和Dukes分期有关。(4)微转移阳性组与微转移阴性组的生存率与复发率差异有统计学意义,阳性组预后较差。(5)CK20与MMP-7检测淋巴结微转移,差异无统计学意义。结论 CK20、MMP-7单克隆抗体免疫组织化学方法有助于检出结直肠癌淋巴结微转移,是判定肿瘤精确分期和预后的一项可靠指标,有助于指导临床治疗,为个体化治疗提供依据。Objective To evaluate the relationship between the clinical pathological factors and the micrometastasis of lymph nodes(LN)and the prognosis of patients with colorectal cancer by detecting CK20 and MMP-7.Methods The lymph nodes of 94 patients with colorectal cancer were stained with hematoxylin and eosin(HE)and immunostained with CK20 and MMP-7 to detect the micrometastasis of lymph nodes.Follow-up was performed for all patients.Results (1)The micrometastasis of lymph nodes was found in 32 of 94 cases,the total micrometastasis rate was 34.04%(32/94)with total micrometastasis degree of 9.64%(35/363).(2)There was significant difference between the group of Dukes A,B and Dukes C stage for the rate of micrometastasis.(3)The micrometastasis of lymph node had only correlation with the differentiation of the tumor and the Dukes staging.(4)There was significant difference of 5-year survival rates and the recurrence rate between the positive group and the negative group.(5)There was no significant difference in the micrometastasis rate and degree detected by CK20 and MMP-7(P>0.05).Conclusions Immunohistochemical staining of CK20 and MMP-7 is a sensitive and simple method for detecting micrometastasis of lymph nodes and it is valuable to re-estimate the stage of colorectal cancer,predict the prognosis accurately and provide evidence for individual treatment.

关 键 词：结直肠肿瘤 淋巴转移 角蛋白20 基质金属蛋白酶7 微转移 

分 类 号：R735.3[医药卫生—肿瘤]