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目的 评价检测原发性乳腺癌腋窝淋巴结微转移的方法。方法 用逆转录聚合酶链反应 (RT PCR)和Southern杂交方法 ,检测腋窝淋巴结中CK 19基因表达。同时与免疫组织化学 (组化 )方法比较其检测敏感性。结果 RT PCR、Southern杂交及免疫组化方法的检测敏感性分别为 1∶5× 10 5、1∶10 6和 1∶5× 10 4 。 5 2例患者的 170枚常规病理检查阴性淋巴结检出微转移 35枚 ,占 2 0 6 %。其中 17例常规病理检查有转移病例的 33枚阴性淋巴结中 ,查出 2 1枚CK 19表达阳性 ;35例淋巴结常规病理检查无转移中有 11例查出微转移 (31 4% )。微转移与其他临床指标无相关性。结论 以CK 19为标志物 ,RT PCR并Southern杂交方法检测原发性乳腺癌淋巴结微转移灵敏、特异 ,可作为临床判断预后的参考指标。
Objective To evaluate the method of detecting micrometastasis of axillary lymph nodes in primary breast cancer. Methods Reverse transcription polymerase chain reaction (RT PCR) and Southern blot were used to detect the expression of CK 19 in axillary lymph nodes. Simultaneously with the immunohistochemistry (histochemistry) method to compare its detection sensitivity. Results The sensitivity of RT PCR, Southern hybridization and immunohistochemistry was 1:5×10 5, 1:10 6 and 1:5×10 4. Of the 52 patients, 170 microscopic metastases were detected in 170 lymph node negative lymph nodes, accounting for 20.6 %. Among the 33 negative lymph nodes with metastases in 17 cases of routine pathological examination, 21 were found to be positive for CK19; 11 cases of 35 lymph node metastases without pathological examination were found to have micrometastasis (31 4%). There was no correlation between micrometastasis and other clinical indicators. Conclusion The CK 19 as a marker, RT PCR and Southern blotting method for the detection of lymph node micrometastasis in primary breast cancer are sensitive and specific. It can be used as a reference index for clinical judgment of prognosis.