摘要
目的：探讨细胞角蛋白CK20 mRNA作为标志物,使用RT-PCR检测结直肠癌系膜淋巴结微转移的临床价值。方法：选择2014年1-8月武汉大学中南医院胃肠外科行结直肠癌根治术切除的肿瘤标本56例,采集其系膜淋巴结,分别用常规HE染色和RT-PCR检测CK20 mRNA,比较RT-PCR在检测淋巴结微转移上的敏感性优势;分析基于两种方法 TNM分期对3年无复发生存率的影响。结果：共检测淋巴结762个,HE染色和RT-PCR法的阳性率分别为40.6%和59.8%,HE染色与RT-PCR法比较其阳性率有显著性差异（P=0.000 1）;56例患者中,按HE染色结果确定的淋巴结分期PN0、PN1和PN2期分别为62.5%、25.0%和12.5%,按RT-PCR法确定的PN0、PN1和PN2期分别为44.6%、28.6%和26.8%,RT-PCR与HE染色比较,淋巴结病理分期升级,有显著性差异（P=0.029）。通过HE染色,PN0、PN1和PN2期患者3年无复发生存率分别为85.7%、78.6%和57.1%,通过RT-PCR技术检测,升级后的PN0、PN1和PN2期3年无复发生存率分别为100%、75.0%和53.3%,同级别之间,在PN0期,两种方法相比差异有显著性（P=0.039）,在PN1和PN2期,两种方法相比差异没有显著性（P=0.089,P=0.127）,显示出RT-PCR技术检测的淋巴结微转移更能提示预后价值。结论：通过RT-PCR法检测CK20 mRNA所发现的淋巴结微转移癌有助于确定结直肠癌临床病理分期和预测患者的预后。
Objective： To use reverse transcription-polymerase chain reaction （RT-PCR） to detect lymph node micrometastases in colorectal cancer, and to determine its value in clinical application. Methods. From January 2014 to August 2014, mesentery lymph nodes specimens from 56 cases that had undergone colorectal cancer radical resection were studied by conventional pathology u- sing hematoxylin and eosine staining（HE） and RT-PCR to detect the expression of CK20 mRNA, respectively. Sensitivity were compared in detecting lymph node metastasis between the two methods. The impact of pathological stage based on micrometastasis on the 3-year recurrence-free survival rate was analyzed. Results： A total of 762 lymph nodes were detected by RT-PCR method. by HE staining and RT-PCR, the positive rates of CK20 were 40.6% and 59.8%, respective- ly, the difference was significant （P=0. 000 1）. In 56 patients, according to HE staining, pro- portion of PN0, PN1, and PN2 stage were 62.5%, 25.0% and 12.5%, respectively. According to RT-PCR method, proportion of PN0, PN1, and PN2 stage were 44.6%, 28.6Y0 and 26.8%, respectively. There was a significant difference between RT-PCR and HE staining （P=0. 029）, and lymph node staging were upgraded by RT-PCR method. By HE staining, the 3-year recur- rence-free survival rate in patients with PN0, PN1, and PN2 stage were 85. 7%, 78. 6% and 57.1%, respectively. By RT-PCR, the 3-year recurrence-free survival rate in patients with up- graded PN0, PN1, and PN2 stage were 100 %, 75.0% and 53.3%, respectively. There was sig- nificant difference at PN0 stage level （P=0. 039） ,while difference was not significant at PN1 and PN2 stage level （P=0. 089, P=0. 127）, showing that lymph node micrometastases detected by RT-PCR technique may have a prognostic value. Conclusion. RT-PCR technique by detecting CK20 mRNA may be useful in inferring the presence of lymph node micrometastasis. RT-PCR using CK20 mRNA marker to detect lymph node micrometastases in colorectal cancer helps to more a
出处
《武汉大学学报（医学版）》
CAS
2018年第2期253-257,共5页
Medical Journal of Wuhan University
基金
湖北省自然科学基金资助项目(编号:2012FFB04413)
