淋巴结阴性乳腺癌骨髓微小转移联合检测的临床研究  

The combined detection of micrometastases in bone marrow and clinical significance in breast cancer patients with axillary lymph nodes negative

作　　者：陈龙舟[1] 赵佳[1] 王凤良[1] 凌立君[1] 刘晓安[1] 王水[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：《南京医科大学学报（自然科学版）》2007年第9期939-942,共4页Journal of Nanjing Medical University(Natural Sciences)

基　　金：江苏省六大人才高峰重点资助(06-0B-70);淮安市科技局科研资助(HAS06052)

摘　　要：目的:探讨腋窝淋巴结病理阴性乳腺癌(axillary lymph nodes negative breast cancer,ALNNBC)采用免疫细胞化学(immunocytochemistry,ICC)和RT-PCR方法同时检测骨髓微小转移的临床意义。方法:乳腺癌患者全身麻醉后行骨髓穿刺采集骨髓血,然后行乳腺癌改良根治术。经常规HE染色证实腋窝淋巴结阴性的乳腺癌患者62例,同时采用ICC和RT-PCR方法检测骨髓微小转移。结果:62例患者中,15例(24.20%)骨髓有KT19mRNA表达,其中9例(14.52%)ICC法也检出KT19阳性细胞,表明在检测骨髓微小转移方面RT-PCR法灵敏度较ICC法更高,两者差异有统计学意义(χ2=4.1667,P=0.0412),两者结果有较好的一致性(kappa=0.6945)。结论:即使常规病理切片检查淋巴结阴性的乳腺癌患者,用ICC法和RT-PCR法对其骨髓血作进一步检测还可发现微小转移的存在,且RT-PCR法比ICC更敏感。Objective：To study the clinical significance of immunocytochemistry（ICC） and reverse transcription-polymerase chain reaction（RT-PCR） in detection of breast cancer micrometastases in bone marrow of breast cancer patients with lymph nodes negative. Methods：After general anesthesia,all patients underwent bone marrow puncture and performed modified radical mastectomy. Bone marrow micrometastases were detected by ICC and RT-PCR in 62 patients, whose axillary lymph nodes showed negative HE-stain. Results：Among the 62 patients,15 cases（24.20%） presented RT-PCR positive,in which 9 cases（14.52%） were also ICC-positive. RT-PCR and ICC showed good uniformity（kappa = 0.6945）,and there was significant difference in detective rate between the two methods（χ^2 = 4.1667,P = 0.0412）. Conclusion：Even there were no axillary lymph nodes involved,micrometastases still could be detected in bone marrow by ICC and RT-PCR. In addition,RT-PCR is more sensitive than ICC.

关 键 词：乳腺肿瘤 微小转移 骨髓 细胞角蛋白 

分 类 号：R737.9[医药卫生—肿瘤]