CAJ | 학술논문

目的探索检测非小细胞肺癌淋巴结微转移的新途径.方法术中将25例非小细胞肺癌患者共195枚淋巴结平均分成两半,一半淋巴结用于常规病理和免疫组织化学染色;另一半淋巴结,按区域混合,用于逆转录聚合酶链反应(RT-PCR).如果一枚淋巴结常规病理证实有显性转移,该患者同一区域的其他淋巴结不再接受免疫组织化学染色或RT-PCR检测.结果 135枚常规病理阴性的淋巴结接受了免疫组织化学染色,31枚淋巴结显现肿瘤微转移.39组常规病理阴性的区域淋巴结混合组织中,11组RT-PCR检测呈阳性.免疫组织化学染色和RT-PCR检测肺癌淋巴结微转移,结果间存在一致性(U=7.682,P=0.0001).结论免疫组织化学染色能提高非小细胞肺癌淋巴结微转移的检出率,并可对部分Ⅰ、Ⅱ期患者重新进行TNM分期.RT-PCR在检测肺癌淋巴结微转移方面,与免疫组织化学染色价值相当.RT-PCR可以简化淋巴结微转移的检测.
목적 탐색검측비소세포폐암림파결미전이적신도경.방법 술중장25례비소세포폐암환자공195매림파결평균분성량반,일반림파결용우상규병리화면역조직화학염색;령일반림파결,안구역혼합,용우역전록취합매련반응(RT-PCR).여과일매림파결상규병리증실유현성전이,해환자동일구역적기타림파결불재접수면역조직화학염색혹RT-PCR검측.결과 135매상규병리음성적림파결접수료면역조직화학염색,31매림파결현현종류미전이.39조상규병리음성적구역림파결혼합조직중,11조RT-PCR검측정양성.면역조직화학염색화RT-PCR검측폐암림파결미전이,결과간존재일치성(U=7.682,P=0.0001).결론 면역조직화학염색능제고비소세포폐암림파결미전이적검출솔,병가대부분Ⅰ、Ⅱ기환자중신진행TNM분기.RT-PCR재검측폐암림파결미전이방면,여면역조직화학염색개치상당.RT-PCR가이간화림파결미전이적검측.
Objective To set up a new method to detect occult micrometasteses of lymph nodes in patients with no-small-cell lung cancer (NSCLC).Methods We had detected 195 lymph node samples taken from 25 patients with NSCLC during the operations.Each lymph node sample was divided into two same Darts in size.The one half part of lymph node should be examined by conventional histopathologic examination and immunohistochemical(IHC)staining.All the remaining lymph node samples of each patient should be mixed together for the reverse transciptase--polymerase chain reaction (RT-PCR)if they located in the same region.As long as the presence of metastatic tumor in one lymph node was found by H&E staining,all other lymph node samples in the same region should not be detected by IHC staining or RT-PCR techniques.Results Frozen tissue sections of 135 lymph nodes that were staged as free of metastases by conventional histopathologic examination were screened by IHC staining.31 lymph nodes showed single cell or cells clusters.Of 39 groups mixed regional lymph nodes which were diagnosed to be devoid of metastases by conventional histopathologic examination.11 groups were found to have positive reactions to cyokeratin 19-mRNA by RT-PCR.There was a correlation between IHC staining and RT-PCR for detection of nodal micrometastases of NSCLC(U=7.682,P=0.0001).Conclusion IHC staining analysis can facilitate the detection of occult micrometastases in lymph nodes of NSCLC.and its assessment of nodal micrometastases can provide a refinement of TNM stage for partial patients with stage Ⅰ toⅡ.RT-PCR has the same value as IHC staining in detection of lymph nodal micrometastases.RT-PCR technique can reduce expense of the detecting micrometastases in lymph nodes.