IHC和PCR法联合检测乳腺癌前哨淋巴结的微转移  

Detection of micrometastases in sentinel lymph node of breast cancer patients by means of IHC and RT-PCR

作　　者：赵佳[1] 王水[1] 刘晓安[1] 刘力嘉[1] 

机构地区：[1]南京医科大学第一附属医院普外科,江苏南京210029

出　　处：《中华肿瘤防治杂志》2006年第16期1229-1231,共3页Chinese Journal of Cancer Prevention and Treatment

基　　金：江苏省科技发展计划(社会发展)科研资助项目(BS2004040)

摘　　要：目的:探讨采用免疫组织化学(IHC)和RT-PCR方法同时检测乳腺癌前哨淋巴结(SLN)微转移的灵敏度及其临床价值。方法:全身麻醉后用1%异硫蓝行腋窝前哨淋巴结活检(SLNB),即刻取1/2SLN投入液氮中保存,然后行乳腺癌改良根治术。经常规病理切片证实包括SLN在内的腋窝淋巴结阴性患者62例,同时采用IHC和RT-PCR方法检测SLN微转移。结果:62例患者中,13例(20·97%)SLN有KT19mRNA表达,其中7例(11·29%)IHC法也检出KT19阳性细胞,表明RT-PCR法灵敏度较IHC法更高,两者差异有统计学意义,χ2=4·1667,P=0·0412;两者检测结果有较好的一致性,kappa=0·6483。另外,比较临床生物学特性和SLN微转移之间关系,未发现有相关因素。结论:常规检查未发现远处和腋窝淋巴结转移的乳腺癌患者,经IHC和RT-PCR法对SLN有针对性的检测可发现微转移的存在,其中RT-PCR方法较IHC更灵敏。OBJECTIVE：To study the value of immunohistochemistry （IHC） and reverse transcription-polymerase chain reaction （RT-PCR） in the detection of micrometastases in sentinel lymph node （SLN） samples from breast cancer patients and evaluate its clinical significance. METHODS： After general anesthetized, all patients were performed sentinel lymph node biopsy （SLNB）. Micrometastases were detected by the above techniques in SLN from 62 breast cancer patients whose axillary lymph nodes were negative for HE-stain. RESULTS： Comparing the different methods in detection of 62 SLN samples, 13 cases were RTPCR-positive, in which 7 cases were also IHC-positive. There was a significant difference in detective rate between these two methods statistically （X^2 =4. 166 7, P=0. 041 2） and the coincidence between PT-PCR and IHC was good （kappa=0. 648 3）. In addition, no correlationship was found statistically between SLN micrometastases and clinical biological features. CONCLUSIONS： Micrometastases can be detected in SLN from patients who are diagnosed no distant metastases by preoperatively regular examination and no axillary lymph node metastases by HE-staining. RT-PCR is more sensitive than IHC in detection of micrometastases.

关 键 词：乳腺肿瘤 活组织检查 角蛋白/分析 淋巴转移 

分 类 号：R737.9[医药卫生—肿瘤]