摘要
目的明确新辅助治疗后以逆转录酶-聚合酶链反应(RT-PCR)法检测前列腺癌盆腔淋巴结微转移的意义。方法本组41例临床局限性前列腺癌病例,术前行淋巴管造影显示盆腔淋巴结,对可疑淋巴结在X线定位下穿刺抽吸淋巴液,用RT-PCR法检测淋巴液中前列腺特异性抗原(prostate-spe-cific antigen,PSA)mRNA和前列腺特异性膜抗原(prostate-specific membrane antigen,PSMA)mRNA的表达;术后对淋巴结组织切片进行免疫组化检查,将PSA mRNA或PSMA mRNA阳性作为存在微转移。结果对术前盆腔淋巴结穿刺抽吸淋巴液测PSA mRNA和PSMA mRNA,证实有21例淋巴结存在微转移,术后对清扫淋巴结予免疫组化检查有5例存在淋巴结转移,组织学检查阳性组与RT-PCR检测证实微转移组PSA mRNA和PSMA mRNA的表达存在明显差异。结论新辅助治疗后,采用RT-PCR法检测淋巴液中PSA mRNA和PSMA mRNA的表达有利于探测到淋巴结微转移。
Objective To clarify the significance of real-time reverse-transcriptase polymerase chain reaction （RT-PCR） in detecting micrometastases of pelvic lymph nodes after neoadjuvant hormonal therapy. Methods The study included 41 patients with clinically localized prostate cancer who received neoadjuvant hormonal therapy （NHT）. If positive lymph nodes are seen or suspected, a thin-walled 22 gauge needle is di- rected transabdomenally under fluoroscopic control into the area and an aspirate is obtained after bipedal lym- phangiography. The expression of prostate-specific antigen （PSA） and prostate-specific membrane antigen （PA- MA） in aspirate were assessed by a fully quantitative real-time reverse-transcriptase polymerase chain reaction. We regarded specimens in which either PSA or PSMAmRNA were positive as showing the ＂presence of micro- metastasis＂. Lymph node specimens were also stained immunohistochemically with an antibody PSA after RP. Results Lymph node metastases from 5 cases were detected bt pathological examination, and real-time RT- PCR further identified lymph node micrometastases from 21 cases with no pathological evidence of nodal involve- ment. The expression level of PSA mRNA and PSMA mRNA were statistically significant in patients with histo- logical confirmed lymph node metastases and micrometastases detected by real-time RT-PCR despite the lack of histological evidence. Conclusion Applying quantitative real-time RT-PCR targeting PSA and PSMA genes candetect micrometastatic tumour foci in pelvic lymph nodes by fine needle aspiration biopsy of lymph nodes.
出处
《东南国防医药》
2012年第5期399-401,共3页
Military Medical Journal of Southeast China
基金
南京军区医学科技创新经费资助项目(07MO58)
关键词
逆转录酶链反应
前列腺肿瘤
前列腺癌根治术
微转移
新辅助治疗
quantitative real-time PCR
prostate cancer
radical prostatectomy
micrometastasis
neoadjuvant hormonal therapy
