RT-PCR法检测胃癌淋巴结微转移  

RT-PCR assay in the detection of micrometastases of the lymph nodes in patients with gastric carcinoma.

作　　者：吴泽宇[1] 詹文华[1] 李靖华[2] 马怡晖[2] 何裕隆[1] 汪建平[1] 彭俊生[1] 蔡世荣[1] 

机构地区：[1]中山大学附属第一医院胃肠胰外科,广州510080 [2]中山大学基础医学院,广州510089

出　　处：《中国实用外科杂志》2004年第12期742-744,共3页Chinese Journal of Practical Surgery

基　　金：国家自然科学基金资助项目 (编号 :3 0 2 712 76) ;"2 11工程"重点学科建设课题资金资助 (编号 :980 97)

摘　　要：目的　应用逆转录聚合酶链反应 (RT PCR)方法检测胃癌淋巴结微转移 ,探讨淋巴结微转移与胃癌生物学行为的关系。方法　对中山大学附属第一医院 2 0 0 3年 12月至 2 0 0 4年 4月间行手术切除的 30例胃癌共85 0枚淋巴结采用CK 2 0mRNART PCR扩增检测微转移 ,分析微转移的临床病理特点。结果　 14例 (46 7% )77枚 (12 5 % )淋巴结检出淋巴结微转移。弥漫型胃癌的微转移阳性率为 6 3 2 % (12 / 19) ,明显高于肠型胃癌的18 2 % (2 / 11,P <0 0 5 )。肿瘤浸润深度越深 ,微转移的检出率越高。结论　CK 2 0mRNART PCR法可以检测出常规病理学检查遗漏的淋巴结微转移 ,可显著提高淋巴结转移的检出率。淋巴结微转移与Lauren分型和浸润深度密切相关。Objective To identify micrometastases of regional lymph nodes in patients with gastric carcinoma using the RT-PCR assay and clarify the relationship between lymph node micrometastases and biological behavior of gastric carcinoma. Methods The authors studied 850 lymph nodes from 30 patients with gastric carcinoma who underwent gastrectomy with lymphadenetomy from December 2003 to April 2004 in First Affiliated Hospital of Zhongshan University using the RT-PCR assay in addition to hematoxylin and eosin (HE) staining. Cytokeratin-20 gene marker was used in this assay. Associations between clinicopathologic characteristics and the presence of lymph node micrometastases were investigated. Results Totally micrometastases were detected only by the RT-PCR assay in 77(12.5%)lymph nodes of 14 patients (46.7%) with gastric carcinoma. The incidence of lymph node micrometastases was significantly higher in the diffuse type (12 of 19 cases, 63.2%) than in the intestinal type of gastric carcinoma (2 of 11 cases, 18.2%, P<0.05). Depth of tumor invasion also had statistically significant correlation with the incidence of lymph node micrometastases. Conclusion The current results indicate that the RT-PCR assay is useful for the detection of micrometastases of regional lymph nodes in patients with gastric carcinoma. The Lauren classification and the depth of tumor invasion are strongly associated with lymph node micrometastases.

关 键 词：淋巴结微转移 胃癌 RT-PCR法 CK-20 检出率 RNA 临床病理特点 结论 深度 方法 

分 类 号：R735[医药卫生—肿瘤] R737[医药卫生—临床医学]