早期宫颈鳞癌盆腔淋巴结微转移的探讨

Pelvic lymph node micrometastasis in patients with early stage cervical squamous cancer

目的:探讨免疫组化法检测早期宫颈鳞癌患者淋巴结内微转移及其临床意义。方法:回顾性分析14例FIGO分期(1995)为ⅠA～ⅡA期宫颈鳞癌患者的临床资料,对术后的228枚盆腔淋巴结的石蜡包埋组织以抗细胞角蛋白抗体AE1/AE3标记。结果:14例228枚淋巴结中,3例患者3枚淋巴结发现微转移病灶,病例总阳性率21.4%,淋巴结总阳性率1.3%。髂外淋巴结组、闭孔淋巴结组的检出率为3.8%(2/53)和1.1%(1/87)。随着临床分期的增加,微转移的检出率逐渐增大(χ2=8.601,P<0.05)。结论:早期宫颈鳞癌患者盆腔淋巴结中存在微转移病灶,可通过免疫组化法检出,对指导治疗、判断预后有积极临床意义。

Objective： To explore the clinical significance of detecting the pelvic lymph node micrometastasis in patients with early stage cervical squamous cancer. Methods ： The medical records of 14 patients with cervical squamous cancer of FIGO （1995） stage Ia to H a who admitted to the First Affiliated Hospital of China Medical University from January 2006 to June 2006 were retrospectively reviewed, A total of 228 formalin-fixed paraffin-embedded pelvic lymph node specimens were serially sectioned and stained with anticytokeratin antibodies AE1/AE3. Results： Among 228 lymph nodes obtained from 14 patients, micrometastasis was found in 3 lymph nodes from 3 patients. The positive rate of micrometastasis was 21.4% （3 of 14 patients）, and the positive rate of lymph nodes was 1, 3% （3 of 228 lymph nodes）, The detection rates of external iliac lymph nodes and obturator lymph nodes were 3.8% and 1.1%, respectively. The positive rate of micrometastasis increased with the progression of clinical stage （ χ^2 = 8. 601, P 〈 0.05 ）. Conclusion： Micrometastasis exists in the pelvic lymph nodes of patients with early stage cervical cancer, and it can be detected by immunohistochemical method.