CK-19抗体在检测非小细胞肺癌淋巴结微转移中的应用

Anti-CK-19 and Its Use in the Detection of Micrometastasis to Lymph Nodes of NSCLC

目的 了解角蛋白 19(CK 19)抗体在检测肺癌淋巴结微转移中的作用。方法 应用免疫组化的方法对5 0例肺癌患者的 10 6个常规病检阴性的淋巴结进行检测 ,分析相关影响因素 ,结合术前血浆肿瘤标志物浓度 ,计算出微转移危险因子 (MRF)计分。结果 CK 19抗体检测的阳性率为 11 3% (12 / 10 6 ) ,阳性病例的比例高达 2 4 %(12 / 5 0 )。单因素分析显示年龄、肿瘤解剖定位 (左 /右肺 )、大小与淋巴结微转移有关 ;多因素分析结果显示 ,淋巴结微转移的危险因子包括肿瘤解剖定位 (左 /右肺 )、大小 ,OR值分别为 1 75、 2 31。当MRF≥ 3时 ,6 2 5 % (5 / 8)发生微转移 ,而MRF <3时 ,仅 8 3% (1/ 12 )发生微转移 ,P <0 0 5。结论 CK 19抗体是检测肺癌淋巴结微转移的有效指标 ,当MRF≥ 3时应注意阴性淋巴结的微转移情况。

Objective To apply anti-cytokeratin-19 (anti-CK-19) in the detection of micrometastasis to lymph nodes of lung cancer.Methods 106 HE negative lymph nodes from 50 lung cancer patients were stained by IHC method and associated factors together with tumor markers were analyzed to calculate micrometastasis risk factors (MRF) score. Results The positive rate of anti-CK-19 stain was 11.3 % (12/106) and positive cases were 12 (24 %). Risk factors for micrometastasis obtained by univariate analysis were age, location of tumor (left vs. right), and tumor size. The significant risk factors noted by multivariate analysis were location of tumor (left vs. right), and size. 62.5 % (5/8) had micrometastasis in those with MRF≥3, compared to 8.3 % in MRF<3, P<0.05.Conclusion Anti-CK-19 is a useful marker in the detection of micrometastasis to lymph nodes of lung cancer. Further investigation should be applied to detect micrometastasis in negative lymph node when MRF≥3.