CK19mRNA检测在判断IA2-IB2期宫颈癌前哨淋巴结微转移中的作用  

Application of CK19mRNA in Evaluating Sentinel Lymph Node Micrometastasis in Patients with Stage IA2-IB2 Cervical Cancer

作　　者：马永静[1] 熊英[1] 刘瑞[1] 

机构地区：[1]宁夏医科大学总医院妇科,银川750004

出　　处：《宁夏医科大学学报》2012年第11期1122-1125,F0004,共5页Journal of Ningxia Medical University

基　　金：宁夏医科大学面上项目(XM201034)

摘　　要：目的检测CK19mRNA在IA2-IB2期宫颈癌前哨淋巴结中的表达,探讨其在判断早期宫颈癌淋巴结微转移中的作用。方法应用荧光定量PCR检测CK19mRNA在IA2-IB2期宫颈鳞癌前哨及非前哨淋巴结中的表达,比较CK19mRNA检测与常规组织病理学检查检出前哨淋巴结微转移的阳性率;分析前哨淋巴结中CK19mRNA的阳性表达与宫颈癌患者临床、病理参数的关系;比较CK19mRNA在前哨与非前哨淋巴结中的阳性表达率。结果 30例IA2-IB2期宫颈鳞癌患者共检出前哨淋巴结86枚,荧光定量PCR与常规组织病理学检测前哨淋巴结微转移的阳性率分别为32.6%和12.8%(P﹤0.05);前哨淋巴结CK19mRNA的阳性表达与宫颈癌患者的临床分期、肿瘤浸润深度、肿瘤直径大小及脉管间隙浸润有关(P<0.05),与患者年龄及肿瘤的分化程度无关(P>0.05);前哨淋巴结中CK19mRNA的阳性表达率明显高于非前哨淋巴结中CK19mRNA的阳性表达率(32.6%和4.5%,P<0.05)。结论与传统组织病理学检查比较,检测CK19mRNA在IA2-IB2期宫颈癌前哨淋巴结中的表达能显著提高微转移检出率,可能成为准确评估早期宫颈癌患者淋巴结微转移的指标和方法,进而能更恰当地指导术后辅助治疗并改善患者的预后。Objective To detect expression of CK19mRNA in sentinel lymph nodes in patients with stage IA2-IB2 cervical cancer,and to explore if CK19mRNA play an important role in judging lymph node micrometastasis in early stage cervical cancer.Methods CK19mRNA was detected in sentinel lymph nodes and no-sentinel lymph nodes of stage IA2-IB2 squamous cell cervical carcinoma by FQ-PCR（fluorescent quantitation-polymerase chain reaction）.The positive rate in sentinel lymph nodes by FQ-PCR was compared with histopathologic diagnosis rate.The relation between CK19mRNA and the patient＇s clinical and pathological parameter was analysed.The positive rate of CK19mRNA was compared in sentinel lymph nodes and no-sentinel lymph nodes.Results 86 sentinel lymph nodes were detected in 30 stage IA2-IB2 cervical cancer.The positive rate of CK19mRNA in sentinel lymph nodes by FQ-PCR（32.6%） was significantly higher than the diagnosis rate of histopathology（12.8%）.Expression of CK19mRNA in sentinel lymph nodes was concerned with clinical stage,deep infiltration of interstitial substance,tumor size and lymph vascular space involvement（P0.05）.It was not concerned with tumor differentiation and the patient＇s age（P0.05）.The positive rate of CK19mRNA in sentinel lymph nodes（32.6%） was significantly higher than that in no-sentinel lymph nodes（4.5%）（P0.05）.Conclusion CK19mRNA is better than histopathology in detecting sentinel lymph node micrometastasis of IA2-IB2 cervical cancer.Therefore,it can evaluate prognosis of patients more exactly and guide adjunctive treatment.

关 键 词：CK19MRNA IA2-IB2期宫颈癌 前哨淋巴结 微转移 

分 类 号：R737.33[医药卫生—肿瘤]