pN0胃癌淋巴结微转移临床意义的研究  

Clinical significance of lymph node micrometastasis in pN0 gastric cancer

作　　者：赵帅[1] 黄允宁 赵良玉 卢林 李智勇 封存志 

机构地区：[1]宁夏医科大学,宁夏银川750002 [2]宁夏人民医院胃肠外科,宁夏银川750002

出　　处：《宁夏医学杂志》2017年第8期682-684,共3页Ningxia Medical Journal

基　　金：宁夏自然科学基金项目(NZ14163)

摘　　要：目的探索联合使用RT-PCR及免疫组织化学染色法(IHC)同时检测胃癌淋巴结微转移(LNM),分析胃癌淋巴结微转移对胃癌临床诊治的影响。方法选取接受手术的p N0期胃癌患者32例。应用IHC和RT-PCR法联合检测术后淋巴结CK20的表达,分析LNM与患者性别、年龄、肿瘤部位、肿瘤大小、浸润深度、分化程度等临床病理资料的关系。结果经IHC法检测出6例患者、共14个淋巴结中CK20阳性,LNM阳性率为21.87%;经RT-PCR法检测出10例患者、共23个淋巴结中CK20 mRNA阳性,LNM阳性率为31.25%。两种方法均为阳性的患者7例,RT-PCR法呈阳性而IHC阴性的患者4例,IHC结果阳性而RT-PCR法阴性患者1例。此研究共检出11例患者存在LNM。不同分化程度p N0期胃癌LNM间差异有统计学意义(P<0.05),低分化胃癌较中-高分化胃癌更易出现LNM。结论胃癌LNM与分化程度有关,低分化胃癌较中-高分化胃癌更易出现微转移,临床医生给低分化胃癌患者采用缩小手术治疗方式时需慎重。IHC和RT-PCR法联合检测胃癌INM可提高微转移的检出率。Objective To determine the lymph node metastasis of patients who undergo surgery with negative lymph node me- tastasis by immunohistochemical staining and reverse transcription polymerase chain reaction （RT -PCR） with CK20 as the target mark- er. To explore the two methods of detecting lymph node micrometastasis and the clinical significance of lymph node micrometastasis in gastric cancer. Methods 32 patients with pN0 gastric cancer who underwent radical gastrectomy were selected. 158 lymph nodes were collected and all lymph nodes were detected by HE staining, pathology diagnosis. The expression of CK20 in lymph nodes was detected by immunohistochemical staining and RT - PCR. To analyze the relationship between lymph node micrometastasis and sex, age, tumor loca- tion, tumor size, depth of invasion, histological type and other clinical pathological parameters of gastric cancer. Results There were sev- en patients and fourteen lymph nodes were positive of lymph node micrometastasis by immunohistochemically stained. The positive rate of lymph node micrometastasis were 21.87% ;A total of 10 patients that were detected by RT - PCR lymph node micrometastasis were posi- tive. The expression of CK20mRNA in 23 lymph nodes was detected by reverse transcription PCR. Lymph node micrometastasis detection rate was 31.25%. Seven patients were positive by both methods. There are 4 patients were positive by RT - PCR and negative by immu- nohistochemistry. One patient had positive immunohistochemical test and negative RT - PCR. There are 11 patients had positive microme- tastasis. There was significant difference between different histological types of pN0 gastric cancer patients （P 〈 0.05）. Lymph node mi- crometastases in patients with poorly differentiated gastric cancer were more likely to occur than patients with moderate to well - differen- tiated gastric cancer. Lymph node micrometastases were associated with histological types of gastric cancer patients, regardless of age, sex, tumor location, tumor size, and dep

关 键 词：胃癌 微转移 CK20 免疫组化法 RT-PCR法 

分 类 号：R735.2[医药卫生—肿瘤]