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目的 :检测原发性乳腺癌常规病理检查阴性淋巴结和骨髓中微转移的发生及与其它临床参考指标的关系。方法 :利用逆转录 聚合酶链反应 (RT PCR)方法联合检测腋窝淋巴结和骨髓中细胞角蛋白 19(CK 19)基因表达。将乳腺癌细胞株 (T47D)与骨髓细胞按不同比例混合 ,比较RT PCR与免疫组化 (IHC)方法的检测敏感性。结果 :35例乳腺癌共 137枚淋巴结有 8例 11枚CK 19表达阳性 ;35份骨髓标本 ,其中 8份CK 19表达阳性。淋巴结或骨髓阳性表达共 14例 (4 0 % )。RT PCR方法能检出 1∶5× 10 5肿瘤细胞 ,而IHC方法仅能检出 1∶5× 10 4 。微转移与其它临床指标未见明显相关性。结论 :以CK 19为标志物 ,RT PCR方法检测原发性乳腺癌微转移灵敏、特异 ,可作为临床判断预后的参考指标
Objective: To detect the occurrence of micrometastases in lymph nodes and bone marrow of routine pathological examination of primary breast cancer and its relationship with other clinical reference indexes. Methods: The expression of cytokeratin 19 (CK 19) in axillary lymph nodes and bone marrow was detected by reverse transcriptase polymerase chain reaction (RT PCR). Breast cancer cell lines (T47D) and bone marrow cells were mixed at different ratios, and the sensitivity of RT PCR and immunohistochemistry (IHC) was compared. Results: A total of 137 lymph nodes in 35 cases of breast cancer were found in 11 cases of CK19 positive expression in 35 cases of myeloma specimens, of which 8 were CK 19 positive. A total of 14 cases (40%) were positive for lymph node or bone marrow. RT PCR method can detect 1: 5 × 10 5 tumor cells, while the IHC method can only detect 1: 5 × 10 4. Micrometastasis and other clinical indicators no significant correlation. CONCLUSION: CK19 is a sensitive and specific marker for the detection of micrometastases in primary breast cancer by RT-PCR, which can be used as a reference index for clinical judgment of prognosis