角蛋白19表达与直肠癌系膜内淋巴结微转移的关系  

Correlation between the expression of Keratin 19 and the micrometastases of rectal carcinoma in mesorectal lymph nodes.

作　　者：韩黔峰[1] 周总光[1] 陈尧[2] 郑阳春[1] 

机构地区：[1]四川大学华西医院消化外科实验室,成都610041 [2]四川大学华西医学中心基础与法医学院解剖教研室,成都610041

出　　处：《中国实用外科杂志》2005年第4期219-221,i003,共4页Chinese Journal of Practical Surgery

基　　金：国家杰出青年基金资助项目 (批准号 3 992 5 0 3 2 )

摘　　要：目的　研究角蛋白19(Keratin 19)的表达与直肠癌所导致直肠系膜内淋巴结微转移的关系。探讨其在预测直肠癌淋巴结微转移中的应用价值。方法　用免疫组化SP法检测2 0 0 2年3～8月收治的80例DukesA ,B ,C ,D期直肠癌组织及其系膜内12 0枚和直肠系膜外5 1枚转移淋巴结中Keratin 19的表达情况,分析其与直肠癌淋巴结转移的相关性。结果　(1)在80例直肠癌病人中,5 7例腺癌上皮Keratin 19表达强于其正常直肠腺上皮Keratin 19的表达,免疫组化染色转移淋巴结的表达程度强于其癌组织表达(P <0 .0 1) ;(2 )有2 5例直肠癌病人直肠系膜内淋巴结HE染色阴性,而免疫组化Keratin 19蛋白染色于其中9例病人的系膜内和系膜外淋巴结分别有11枚(9. 17% )和5枚(9 8% )染色阳性;(3) 80例直肠癌病人直肠系膜淋巴结内癌细胞免疫组化染色平均灰度值与直肠癌原发灶癌细胞免疫组化染色平均灰度值相关性分析显示有相关性(P <0 . 0 1)。结论　80例直肠癌病人直肠系膜淋巴结内转移癌细胞Keratin 19蛋白表达强于直肠癌原发灶癌细胞的表达,直肠癌细胞Ker atin 19蛋白的阳性表达与直肠癌淋巴结微转移呈正相关关系。Keratin 19在DukesC/D期直肠癌内的表达显著高于其在DukesA/B期内的表达。KeratinObjective To study the correlation between the expression of Keratin 19 and the micrometastases of rectal carcinoma in mesorectal lymph nodes.Methods The expression of Keratin 19 in paraffin-embedded specimens of 80 patients with rectal carcinoma in Dukes A,B,C,D (admitted from March 2002 to August 2002) and their 120 mesorectal lymph nodes and 51 lymph nodes out of mesorectum with metastases were detected by SP method of immunohistochemistry.The correlation between the expression of Keratin 19 and the micrometastases of rectal carcinoma in the mesorectal lymph nodes were analyzed.Results (1)Among the 80 patienis with rectal carcinoma,57 cases showed higher expression of keratin 19 than that of normal mucosa.The expression of Keratin 19 for tumor cells in the metastastic lymph nodes of rectal carcinoma was significantly higher than that in primary lesion ( P <0.01).(2)Among 25 patients who had not been positive for mesorectal lymph nodes metastases with HE,Keratin 19 staining was positive for 11 lymph nodes in 6 patients.(3) The correlation analysis of average grey scores in immunohistochemical staining with metastastic tumor cells and primary lesion of rectal carcinoma was showed ( P <0.01).Conclusion The expression of Keratin 19 in the metastastic mesorectal lymph nodes of rectal carcinoma was higher than that in primary lesion of rectal carcinoma and the expression of the Keratin 19 in the rectal carcinoma cells paralleled in mesorectal lymph nodes' micrometastases of rectal carcinoma.The expression of keratin19 in Dekes C/D was significantly higher than that in Dukes A/B.The cytoplasmic and nuclear expression in tumors was not associated with the clinical feature of patients age.

关 键 词：淋巴结微转移 角蛋白19 直肠系膜淋巴结 免疫组化染色 直肠癌淋巴结转移 免疫组化SP法 转移淋巴结 平均灰度值 2002年 直肠癌组织 相关性分析 转移癌细胞 直肠癌细胞 DUKES 应用价值 表达情况 组织表达 表达程度 HE染色 

分 类 号：R735.2[医药卫生—肿瘤] R739.5[医药卫生—临床医学]