次级淋巴组织趋化因子检测胃癌淋巴结微转移

Secondary Lymphoid Tissue Chemokine mRNA Determination of Lymph Node Micrometastasis in Patients with Gastric Cancer

[目的]探讨次级淋巴组织趋化因子(SLC)mRNA联合检测预测淋巴结微转移对胃癌病人的临床意义。[方法]分别用SLCmRNART-PCR方法、细胞角蛋白CK20免疫组化染色法、常规病理学方法检测2003年至2006年间手术的35例胃癌病人的523个淋巴结。[结果]14例胃癌患者63个淋巴结免疫组化和常规组织学检查未证实淋巴结转移,而SLCmRNA表达减弱,提示存在隐匿性转移。分化差的患者微转移发生率高于分化好的患者。[结论]SLCmRNA联合细胞角蛋白CK20免疫染色以及常规组织学检查可更准确地发现淋巴结微转移灶,有利于判断胃癌病人的预后。

[Purpose] To explore the significance of combined measurement of secondary lymphoid tissue chemokine mRNA for prediction micrometastasis of lymph nodes in patients with gastric cancer. [Methods] Five hundred and twenty-three lymph nodes removed from 35 cases with gastric cancer during 2003 to 2008 were examined by immunohistochemistry of cytokeratin and SLCmRNA RT-PCR. [Results] In 14 cases （63 lymph nodes） with gastric cancer, expression of SLCmRNA was reduced suggesting unconfirmed micrometastasis with immunohistochmical method and routine pathological method. The incidence of micrometastasis in un-differentiated carcinoma was higher than that in differentiated carcinoma. [Conclusion] Detection of lymph node micrometastasis and accuracy prediction of prognosis in patients with gastric cancer should be greatly enhanced if cytokeratin-specific immunohistochemstry, SLCmRNA and routine histopathological examination of lymph nodes are all adopted.