淋巴结显示液联合CK19在乳腺癌腋窝淋巴结检测中的临床意义  

Clinical significance of lymph node revealing solution combining CK19 in detecting axillary lymph node in breast carcinoma

作　　者：张昊[1] 吴云飞[2] 

机构地区：[1]辽宁省肿瘤医院肿瘤外科,沈阳110042 [2]中国医科大学附属第一医院乳腺外科,沈阳110001

出　　处：《中国肿瘤临床与康复》2011年第5期395-397,共3页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨淋巴结显示液(LNRS)联合CK19在乳腺癌腋窝淋巴结检出及微转移灶检测中的临床意义。方法 58例经根治性手术乳腺癌标本分别应用传统法和LNRS法检出淋巴结,应用HE染色检测淋巴结转移状况,HE染色阴性淋巴结进一步行CK19免疫组织化学检测微转移病灶。结果传统法检出淋巴结774枚,HE染色pN0期患者37例(淋巴结463枚);应用LNRS处理后多检出淋巴结469枚,HE染色pN0期患者45例(淋巴结332枚);传统法和LNRS法HE染色均为pN0期的患者35例(传统法淋巴结441枚及LNRS法淋巴结244枚,共685枚)。685枚淋巴结进一步行CK19免疫组织化学检测,5例患者(淋巴结17枚)发现微转移病灶。传统法pN0期的患者中有13.5%(5/37)的患者分期移动为pN1mi;传统法pN0期的患者中有5.4%(2/37)的患者分期移动为pN1;传统法pN1期的患者中有16.7%(2/12)的患者分期移动为pN2;传统法pN2期的患者中有14.3%(1/7)的患者分期移动为pN3,总体上共有17.2%(10/58)的患者发生了N分期的移动。结论应用LNRS能够显著提高乳腺癌腋窝淋巴结检出数量,行CK19免疫组织化学检测微转移病灶,可更准确地反映乳腺癌腋窝淋巴结的转移状态,对于评估N分期及指导术后治疗有一定临床意义。Objective To study the clinical significance of lymph node revealing solution（LNRS） and CK19 in detecting axillary lymph node and micrometastasis in breast carcinoma.Methods 58 cases of breast specimens from patients who underwent radical operation were treated with traditional method and LNRS method to retrieve lymph nodes respectively.All identified lymph nodes were submitted to hematoxylin and eosin（HE） examination,the HE negative lymph nodes were followed CK19 immunohistochemical（IHC） staining for micrometastasis.Results There were 774 lymph nodes detected by traditional method and 37 patients（463 lymph nodes） were pN0 stage stained by HE;an further application of LNRS identified 469 additional lymph nodes and 45 patients（332 lymph nodes） were pN0 stage stained by HE;35 patients were pN0 stage both traditional and LNRS method stained by HE（traditional method 441 lymph nodes and LNRS method 244 lymph nodes,total 685 lymph nodes）.The 685 lymph nodes were examined by CK19 IHC staining detected 5 patients（17 lymph nodes） with micrometastasis.N stage migration was observed in 13.51%（5/37） of patients with pN0 disease by traditional method to pN1mi,5.41%（2/37） of patients with pN0 disease by traditional method to pN1,16.67%（2/12） with pN1 disease by traditional method to pN2,14.28%（1/7） with pN2 disease by traditional method to pN3 and totally 17.24%（10/58） patients were observed N stage migration.Conclusion Using LNRS increase the amount of lymph nodes detected in breast specimens obviously,to assess the lymph nodes status more accurately,CK19 IHC staining for micrometastasis would be greatly valuable in N stage determination and disease treatment postoperatively.

关 键 词：乳腺癌 腋淋巴结 微转移 淋巴结显示液 CK19 

分 类 号：R737.9[医药卫生—肿瘤] R730.45[医药卫生—临床医学]