论文部分内容阅读
目的 探讨Ⅰ期乳腺癌患者腋淋巴结微小转移及其与nm2 3表达的关系。方法 对5 2例Ⅰ期乳腺癌患者的原发癌灶及常规病理学检查未发现癌转移的 832枚腋淋巴结 ,用抗上皮细胞膜 (EMA)及nm2 3 H1单克隆抗体分别进行免疫组织化学染色。结果 被检病例的 2 3% (12 /5 2 ) ,淋巴结的 4% (34/832 )存在淋巴结内癌的微小转移 ;淋巴结微小转移癌在高分化 12 % (4 /32 )及低分化40 % (8/2 0 )癌组中的差异有显著意义 (P <0 0 1) ;5 1% (2 7/5 2 )乳腺癌组织中nm2 3为阳性表达。nm2 3阳性表达率在淋巴结微小转移癌组为 2 5 % (3/12 ) ,在非转移组为 6 0 % (2 4/4 0 ) ,两组之间的差异有显著意义 (P <0 0 5 )。结论 以单克隆抗体 (单抗 )EMA为探针 ,采用免疫组织化学技术 ,可发现常规病理学检查难以确认的Ⅰ期乳腺癌患者的腋淋巴结微小转移。nm2 3表达下降在乳腺癌转移早期阶段即可发生。
Objective To investigate the micrometastasis of axillary lymph nodes and its relationship with the expression of nm23 in patients with stage I breast cancer. Methods The primary foci of 52 patients with stage Ⅰ breast cancer and 832 axillary lymph nodes were not detected by routine pathological examination. Immunohistochemical staining was performed with anti-epithelial membrane (EMA) and nm2 3 H1 monoclonal antibody . Results Twenty-three percent (12/5 2) of the examined cases and 4% (34/832) of the lymph nodes showed micrometastases in the lymph node. The micrometastases in the lymph nodes were highly differentiated in 12% (4/32) and poorly differentiated The difference was statistically significant (P <0.01) in 5% (8/2 0) of breast cancers and nm23 in 5 of 11 (27/5) breast cancers. The positive expression rate of nm23 in lymph node micrometastasis group was 25% (3/12), and in non-metastasis group was 60% (24/40), the difference between the two groups was significant (P <0 0 5). Conclusion Using monoclonal antibody (mAb) EMA as a probe and using immunohistochemical technique, micrometastasis of axillary lymph nodes in patients with stage Ⅰ breast cancer that can not be confirmed by routine pathological examination can be found. nm23 expression decline in the early stages of breast cancer metastasis can occur.