结直肠癌前哨淋巴结微转移分子检测及临床意义  

Molecule detection and its clinical significiance of micrometastasis of SLNs in colorectal carcinoma

作　　者：林贤东[1] 郑雄伟[1] 张红[1] 力超[1] 陈刚[1] 翁秀琴[1] 应敏刚[2] 

机构地区：[1]福建省肿瘤医院病理科,福建福州350014 [2]福建省肿瘤医院外科,福建福州350014

出　　处：《中华肿瘤防治杂志》2006年第20期1571-1574,共4页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的:探讨结直肠癌前哨淋巴结(sentinellymphnode,SLN)定位和前哨淋巴结微转移检测的临床意义。方法:对52例结直肠癌患者,术前用异硫蓝标记法标记SLN并定位,用RT-PCR法检测SLN中CK20mRNA的表达。同时与常规病检法比较其检测敏感性。并分析结直肠癌转移与各种病理因素关系。结果:SLN定位成功率为96%,SLN状态与非SLN的符合率为100%。RT-PCR法与常规病检法转移的检出率相比较差异有统计学意义,P=0·039。在常规病检阴性的40例淋巴结中,RT-PCR法检出8例有微转移。结直肠癌转移与肿瘤侵袭深度、分化程度、Duke’s分期密切关系。结论:SLN技术运用于结直肠癌将更方便、更准确判断淋巴结转移情况。RT-PCR法较常规病理检查更为敏感,通过SLN定位和RT-PCR的联合使用,可明显提高结直肠癌SLN微转移的检出率。并提高结直肠癌临床分期,为结直肠癌进一步治疗提供理论依据。OBJECTVE：To investigate the clinical significance of location of sentinel lymph nodes （SLN） and detection of the sentinel lymgh node micrometastases in colorectal carcinoma. METHOD： In 52 colorectal carcinoma cases, the SLNs were identified by Isosulfan Blue and located, and furthermore RT-PCR was used to examined the expression of CK20 rnRNA of SLNs. The sensitivity of the method of RT-PCR was compared with that of the routine pathological examination. At the same time, the relation between various clini- cal pathological parameters and the metastasis of coloretal carcinoma was studled. RESULTS： SLN was successfully identified in 50 of 52 cases （96%）, the positive predictive value of 100 percent was found when sentinel lymph nodes were identified. The metastasis detection of SLN with RT-PCR had significant difference with the routine pathologic examination （P = 0. 039）. Eight out of 40 metastasis negative patients detected by the routine pathological examination were CK20 gene positive detected by RT-PCR examination. The metastasis of colorectal carcinoma had a positive correlation with Dukes＇s tage, differentiation and invasion of cancer. CONCILUSIONS： Application of the sentinel lymph node technique to colorectal carcinoma may make it easier to identify lymph nodes most likely to contain mestastatic disease. The examination of RT-PCR is more sensitive than the routine pathological examination for the detection of The combinated utilization of locating SLN and RT-PCR can greatly improve the efficiency of micrometastasis in SLNs, which improves accuracy rate of staging in colorectal carcinoma. Furt hmore, it will offer theoretical foundution in the treatment of colorectal carcinoma.

关 键 词：结直肠肿瘤/病理学 肿瘤转移 前哨淋巴结 逆转录聚合酶链反应 

分 类 号：R735.3[医药卫生—肿瘤]