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目的:探讨L选择素(L-selectin)在乳腺癌前哨淋巴结(SLN)中的表达,分析乳腺癌SLN状况与L选择素表达的关系。方法:选择T1-2N0M0乳腺癌患者68例,以亚甲蓝为示踪剂先行前哨淋巴结活检术(SLNB),应用免疫组织化学法检测本组68例乳腺癌SLN,乳腺癌原发灶,癌旁乳腺组织以及20例III级不典型增生乳腺组织中L选择素的表达。结果:68例乳腺癌患者中SLN检出成功62例,检出率为91.17%(62/68),其中假阴性3例(3/32)。阳性SLN中L选择素阳性表达率明显高于乳腺癌组织、癌旁组织(均P<0.05)。SLN阳性患者其原发灶L选择素阳性表达率明显高于SLN阴性患者(P<0.05)。SLN及非前哨淋巴结(NSLN)均阳性患者其原发灶L选择素阳性表达率明显高于SLN及NSLN均阴性患者(P<0.001)。结论:L选择素在阳性SLN转移癌中表达增高,提示L选择素在乳腺癌细胞的淋巴结趋向性中起重要作用;SLN状态与L选择素阳性表达有密切关系,两者相结合分析可以更全面地反映乳腺癌转移规律及腋淋巴结状态。
Objective: To investigate the expression of L-selectin in sentinel lymph node (SLN) of breast cancer and to analyze the relationship between SLN status and L-selectin expression in breast cancer. Methods: Seventy-six patients with T1-2N0M0 breast cancer were selected and sentinel lymph node biopsy (SLNB) with methylene blue as tracer. Immunohistochemistry was used to detect the expression of SLN in breast cancer, primary breast cancer, Parathyroid tissue and 20 cases of grade III atypical hyperplasia of breast tissue L-selectin expression. Results: Sixty-six cases of SLN were detected in 68 cases of breast cancer. The detection rate was 91.17% (62/68), of which 3 cases were false negative (3/32). The positive rate of L-selectin in positive SLN was significantly higher than that in breast cancer and adjacent tissues (all P <0.05). The positive rate of L-selectin in SLN-positive patients was significantly higher than that in SLN-negative patients (P <0.05). The positive rate of L-selectin in SLN-positive and non-SLN-positive patients was significantly higher than that in SLN and NSLN-negative patients (P <0.001). Conclusion: The increased expression of L-selectin in positive SLN metastatic carcinomas suggests that L-selectin plays an important role in the lymph node induction of breast cancer cells. The SLN status is closely related to the positive expression of L-selectin. A comprehensive reflection of breast cancer metastasis and axillary lymph node status.