Ⅰ_a-Ⅱ_a期宫颈癌患者盆腔淋巴结中高危型HPV DNA及CK19的检测及其意义  

Detection of high-risk HPV DNA and CK19 in pelvic lymph nodes in stageⅠ_a-Ⅱ_a cervical cancer and its significance

作　　者：张帆[1,2] 林蓓[1] 郝莹莹[1] 周丹[1] 王冬冬[1] 齐跃[1] 董伟妍[1] 朱连成[1] 张淑兰[1] 

机构地区：[1]中国医科大学附属盛京医院妇产科,沈阳110004 [2]北京市海淀区妇幼保健院妇产科,北京海淀100080

出　　处：《现代肿瘤医学》2009年第9期1742-1746,共5页Journal of Modern Oncology

基　　金：辽宁省攻关项目(编号:2003225004);辽宁省攻关项目(2005225007-2);沈阳市科技攻关项目(1053125-1-54-1)

摘　　要：目的:分别采用原位杂交法和免疫组化法检测早期宫颈癌盆腔淋巴结中高危型HPV DNA和CK19的表达,探讨早期宫颈癌微小转移的检测率及检测方法。方法:选取28例早期宫颈癌患者常规病理光镜检查证实转移和未转移淋巴结共104个,分别采用原位杂交法和免疫组化法检测高危型HPV DNA和CK19的表达。结果:所有常规病理检查阴性的80个淋巴结中高危型HPV DNA的阳性检出率为45%(36/80);CK19的检出率为25%(20/80)。常规病理光镜检查证实淋巴未转移患者的57个淋巴结中23个高危型HPV DNA阳性(43.5%),来自15名患者中的9人(60%);14个淋巴结CK19阳性(24.6%),来自15名患者中的7名(46.6%)。患者的微转移检出率分别为60%和46.6%。两种检测方法的结果有较好的一致性。高危型HPV DNA的检出率高于CK19(P<0.001)。结论:原位杂交法检测高危型HPV DNA,免疫组化法测CK19均可检测出早期宫颈癌淋巴微转移,原位杂交法是分子水平的检测,在宫颈癌淋巴微转移的检测中可能更敏感可靠。Objective：To investigate the detection rate and method of micrometastases of cervical cancer in early - stage by detecting the expression of high - risk HPV DNA and cytokeratin19 （ CK19 ） in pelvic regional lymph nodes of cervical cancer patients in Ⅰ a - Ⅱ a stage using in situ hybridization and immunohistological method ,respectively. Methods：The 104 lymph nodes were collected from 28 patients with cervical cancer in early - stage. Conventional histopathologic techniques revealed 24 metastatic lymph nodes from 13 out of 28 patients. The expressions of high - risk HPV DNA by in site hybridization （ ISH ） and cytokeratinl9 （ CK19 ） by immunohistochemistry （IHC） were detected in all 104 pelvic lymph nodes. Results：Expression of high- risk HPV DNA by ISH and CK19 by IHC were 36 （45%） and 20 （25 % ） of 80 histologically uninvolved lymph nodes, respectively. Of 57 lymph nodes from 15 patients without metastatic lymph nodes on conventional histopathologic techniques, 23 （43.5%） were positive for high -risk HPV DNA and 14（24.6% ） were positive for CK19,from 9（60% ） and 7（46.6% ） in 15 patients,respectively. The outcome of these two methods was in good consistency. The detect rate of high - risk HPV DNA was higher than that of CK19 （ P 〈 0. 001 ）. The detect rates of micrometastases by two methods were 60% and 46.6%, respectively. Conclusion： ISH and IHC are more sensitive to identify micrometastases in pelvic lymph nodes of patients with early - stage cervical cancer than routine pathological method, while ISH, the molecular assessment of the lymph nodes, is more sensitive in those two. Therefore, ISH may be a more reliable and valuable method to replenish the routine histologic examination for cervical cancer.

关 键 词：人类乳头状病毒 宫颈癌 淋巴结微转移 原位杂交 角蛋白19 免疫组织化学 

分 类 号：R737.33[医药卫生—肿瘤]