陳波 1 , 陸云飛 2 , 曾健 2 , 何生 1
  • 1.四川大學(xué)華西醫(yī)院普外科（成都610041）;;
  • 2.廣西醫(yī)科大學(xué)第一附屬醫(yī)院普外科（南寧530021）;

【摘要】目的探討檢測(cè)乳腺癌腋窩淋巴結(jié)轉(zhuǎn)移較敏感的方法。
方法應(yīng)用常規(guī)HE染色法、細(xì)胞角蛋白19（CK19）作為單抗的免疫組化（IHC）SP染色及CK19 mRNA的逆轉(zhuǎn)錄聚合酶鏈反應(yīng)（RT-PCR）3種方法檢測(cè)20例乳腺癌患者共239個(gè)腋窩淋巴結(jié)的轉(zhuǎn)移情況。
結(jié)果239個(gè)腋窩淋巴結(jié)中，HE染色發(fā)現(xiàn)3例患者7個(gè)（2.9%，7/239）有癌轉(zhuǎn)移，均位于level Ⅰ； IHC檢測(cè)到7例患者13個(gè)（5.4%，13/239）有癌轉(zhuǎn)移，其中11個(gè)位于level Ⅰ，2個(gè)位于level Ⅱ； RT-PCR檢測(cè)到14例患者52個(gè)（21.8%，52/239）有癌轉(zhuǎn)移，其中30個(gè)位于level Ⅰ，22個(gè)位于level Ⅱ。IHC和RT-PCR檢測(cè)證實(shí)，HE染色陽性的7個(gè)淋巴結(jié)均有癌轉(zhuǎn)移； IHC染色陽性的淋巴結(jié)均出現(xiàn)了PCR陽性擴(kuò)增產(chǎn)物。HE、IHC及RT-PCR 3種檢測(cè)方法對(duì)腋窩淋巴結(jié)微轉(zhuǎn)移的檢出率分別是0(0/232)、2.6%(6/232)及19.4%(45/232），P＜0.05。
結(jié)論 IHC及RT-PCR是較HE檢測(cè)淋巴結(jié)微轉(zhuǎn)移更敏感的方法，而RT-PCR較IHC更為敏感，能更準(zhǔn)確地反映乳腺癌患者腋窩淋巴結(jié)的狀況。

引用本文： 陳波,陸云飛,曾健,何生. HE、IHC和RTPCR方法檢測(cè)乳腺癌腋窩淋巴結(jié)轉(zhuǎn)移的對(duì)照研究. 中國普外基礎(chǔ)與臨床雜志, 2005, 12(3): 238-240. doi: 復(fù)制

版權(quán)信息： ?四川大學(xué)華西醫(yī)院華西期刊社《中國普外基礎(chǔ)與臨床雜志》版權(quán)所有，未經(jīng)授權(quán)不得轉(zhuǎn)載、改編

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  2. 2. Noguchi S, Aihara T, Motomura K, et al. Detection of breast cancer micrometastases in axillary lymph nodes by means of reverse transcriptasepolymerase chain reaction. Comparison between MUC1 mRNA and keratin 19 mRNA amplification [Ｊ]. Am J Pathol, 1996; 148(2)∶649.
  3. 3. Schoenfeld A, Luqmani Y, Smith D, et al. Detection of breast cancer micrometastases in axillary lymph nodes by using polymerase chain reaction [Ｊ]. Cancer Res, 1994; 54(11)∶2986.
  4. 4. International(Ludwig)Breast Cancer Study Group.Prognostic importance of occult axillary lymph node micrometastases from breast cancer [Ｊ]. Lancet, 1990; 335(8705)∶1565.
  5. 5. Noguchi S, Aihara T, Nakamori S, et al. The detection of breast carcinoma micrometastases in axillary lymph nodes by means of reverse transcriptasepolymerase chain reaction [Ｊ]. Cancer, 1994; 74(5)∶1595.
  6. 6. Silverstein MJ, Gierson ED, Waisman JR, et al. Axillary lymph node dissection for T1a breast carcinoma. Is it indicated? [Ｊ]. Cancer, 1994; 73(3)∶664.
  7. 7. Giuliano AE, Kirgan DM, Guenther JM, et al. Lymphatic mapping and sentinel lymphadenectomy for breast cancer [Ｊ]. Ann Surg, 1994; 220(3)∶391.