检测胃癌淋巴结微转移的临床意义  

The Clinical Significance of Micrometastasis in Lymph Nodes of Gastric Cancer

作　　者：谢洪虎[1] 朱海颖 

机构地区：[1]常州市第一人民医院胃肠外科,江苏常州213003 [2]江苏省工人常州疗养院老年科,江苏常州213003

出　　处：《常州实用医学》2014年第2期71-74,共4页CHANGZHOU PRACTICAL MEDICINE

摘　　要：目的使用实时荧光定量PCR（qRT-PCR）法检测胃癌淋巴结的微转移情况，探讨微转移的临床意义。方法收集常州市第一人民医院2012年6～12月50例行胃癌根治术切除的328枚和10例行胃十二指肠溃疡手术切除的22枚（共计350枚）淋巴结标本，以CEA、CK-19和CK-20为引物进行qRT-PCR检测其微转移情况，分析微转移的临床病理特点。结果50例胃癌患者中有31例共33枚淋巴结检测出有微转移；10例胃溃疡的22枚淋巴结标本HE染色检测和qRT-PCR检测均为阴性。淋巴结微转移的阳性率与肿瘤分化程度、浸润深度和临床分期有关（P〈0．05）。结论qRT-PCR是检测胃癌淋巴结微转移敏感且特异的方法，对胃癌临床分期、判断预后以及治疗方案选择具有重要意义。Objective To identify mierometastasis in regional lymph nodes of gastric cancer use Quantitative Real - Time Reverse Transcription- PCR（qRT - PCR） assay and evaluate the clinical signiificance of micrometastasis. Methods Study 328 lymph nodes from 50 patients with gastric cancer who had undergone a standard gastrectomy with lymphadcnetomy and 10 patients with gastroduodenal ulcer from January 2012 to June 2012 in Changzhou First People＇ s Hospital, using the qRT- PCR assay in ad- clifton to hematoxylin and eosin（HE） staining. Carcinoembryonic antigen （CEA）, cytokeratin 19 （CK19） and cytokeratin 20 （CK20） gene marker were used in this assay.Associations between clinieopathologic characteristics and the presence of lymph node mi- crometastases were investigated. Results Totally micrometastases were detected only by the qRT- PCR assay in 33 lymph nodes of 31 patients. 22 lymph nodes from 10 patients with gastric ulcer were negative by real - time RT - PCR and H＆E.The differenti- ation, depth of gastric mural invasion and clinical stage had statistically significant correlation with the incidence of lymph node mi- crometastases（ P 〈 0.05）. Conclusion qRT - PCR assay is a sensitive and specfic method to detect lymph node micrometastases in gastric cancer patients, and it has importantly clinicaU significance in evaluating clinical staging, prognosis and treatment pre- scription.

关 键 词：胃癌 淋巴结 微转移 实时荧光定量PCR 

分 类 号：R735.2[医药卫生—肿瘤]