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目的探讨淋巴结显示液(LNRS)联合CK19在乳腺癌腋窝淋巴结检出及微转移灶检测中的临床意义。方法 58例经根治性手术乳腺癌标本分别应用传统法和LNRS法检出淋巴结,应用HE染色检测淋巴结转移状况,HE染色阴性淋巴结进一步行CK19免疫组织化学检测微转移病灶。结果传统法检出淋巴结774枚,HE染色pN0期患者37例(淋巴结463枚);应用LNRS处理后多检出淋巴结469枚,HE染色pN0期患者45例(淋巴结332枚);传统法和LNRS法HE染色均为pN0期的患者35例(传统法淋巴结441枚及LNRS法淋巴结244枚,共685枚)。685枚淋巴结进一步行CK19免疫组织化学检测,5例患者(淋巴结17枚)发现微转移病灶。传统法pN0期的患者中有13.5%(5/37)的患者分期移动为pN1mi;传统法pN0期的患者中有5.4%(2/37)的患者分期移动为pN1;传统法pN1期的患者中有16.7%(2/12)的患者分期移动为pN2;传统法pN2期的患者中有14.3%(1/7)的患者分期移动为pN3,总体上共有17.2%(10/58)的患者发生了N分期的移动。结论应用LNRS能够显著提高乳腺癌腋窝淋巴结检出数量,行CK19免疫组织化学检测微转移病灶,可更准确地反映乳腺癌腋窝淋巴结的转移状态,对于评估N分期及指导术后治疗有一定临床意义。
Objective To investigate the clinical significance of lymph node display fluid (LNRS) combined with CK19 in axillary lymph node detection and micrometastasis detection in breast cancer. Methods Fifty-eight cases of radical surgery breast cancer specimens were detected by conventional method and LNRS respectively. Lymph node metastasis was detected by HE staining. Negative lymph nodes of HE staining were used to detect micrometastasis in CK19 immunohistochemistry. Results Seven hundred and seventy lymph nodes were detected by HE method and 373 patients with pN0 HE stain (463 lymph nodes). A total of 469 lymph nodes were detected after LNRS treatment, and 45 patients with pN0 HE staining (332 lymph nodes) Methods HE staining were pN0 in patients with 35 cases (441 traditional lymph node and LNRS lymph node 244, a total of 685). 685 lymph nodes further CK19 immunohistochemical detection, 5 patients (17 lymph nodes) found that micrometastasis. 13.5% (5/37) of the patients in the traditional pN0-phase had a staging shift of pN1mi; 5.4% (2/37) of the patients in the traditional pN0-phase had a staging shift of pN1; the patients in the traditional pN1-phase , 16.7% (2/12) of patients had a staging shift of pN2; 14.3% (1/7) of patients in the traditional pN2-phase had a staging shift of pN3 and a total of 17.2% (10/58) of patients N staging has occurred. Conclusion The application of LNRS can significantly increase the number of axillary lymph nodes in breast cancer, and CK19 immunohistochemical detection of micrometastases can reflect the metastatic status of axillary lymph nodes more accurately, which is of clinical significance for evaluating the N stage and guiding the postoperative treatment .