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目的检测癌胚抗原(CEA)mRNA在Ⅰ期非小细胞肺癌N2淋巴结中的表达,对其与微转移及预后等相关性进行初步分析。方法 2005年至2010年我院160例术后经病理证实为Ⅰ期NSCLC患者,分别选取其肿瘤组织及隆突下(N2)淋巴结,另取10例术后证实肺良性疾病患者淋巴结作为对照组,采用实时荧光定量RT-PCR的方法检测其CEAmRNA的表达,并分析其表达与肿瘤大小、病理类型及预后等相关性。结果 CEA mRNA在160例肺癌组织中有142例表达(142/160),160枚N2淋巴结中19枚有表达(19/160);在腺癌患者N2淋巴结中的表达率明显高于鳞癌;ⅠB期患者N2淋巴结中的表达率高于ⅠA期;在10例肺良性疾病患者淋巴结中均未见CEA mRNA表达。生存分析显示,N2淋巴结CEA mRNA表达患者5年生存率明显低于不表达患者。结论Ⅰ期NSCLC患者N2淋巴结中CEAmRNA表达提示可能存在微转移,且预后较差。腺癌N2淋巴结微转移率可能高于鳞癌。ⅠB期患者预后较IA期差,可能与其N2淋巴结微转移率较高有关。
Objective To detect the expression of carcinoembryonic antigen (CEA) mRNA in N2 lymph nodes of stage I non-small cell lung cancer and to analyze its correlation with micrometastasis and prognosis. Methods From 2005 to 2010, 160 patients with pathologically confirmed stage Ⅰ NSCLC in our hospital were enrolled. Tumor tissues and subnuclear lymph nodes (N2) were selected. Another 10 patients with postoperative lung benign disease were selected as control group The expression of CEAmRNA was detected by real-time fluorescence quantitative RT-PCR. The correlation between the expression of CEAmRNA and tumor size, pathological type and prognosis was analyzed. Results The expression of CEA mRNA in 142 of 160 lung cancer tissues (142/160) and 19 of 160 N2 lymph node tissues (19/160) was significantly higher than that in squamous cell carcinoma; The expression rate of N2A in stage IB patients was higher than that in stage IA; CEA mRNA expression was not found in lymph nodes in 10 cases of benign lung diseases. Survival analysis showed that the 5-year survival rate of patients with N2 lymph node CEA mRNA expression was significantly lower than that of non-expression patients. Conclusion The expression of CEAmRNA in N2 lymph nodes of patients with stage Ⅰ NSCLC may suggest micrometastasis and the prognosis is poor. Adenocarcinoma N2 lymph node micrometastasis rate may be higher than squamous cell carcinoma. The prognosis of stage IB patients is worse than that of stage IA, which may be related to the higher rate of N2 lymph node micrometastasis.