免疫组化和连续切片在检测头颈鳞癌颈淋巴结微转移中的意义

Immunohistochemistry and serial section in detection of lymph node micrometastasis of head and neck squamous cell carcinoma

目的探讨应用连续切片EnvisionTM法检测角蛋白表达对判断头颈鳞状细胞癌淋巴结微转移的效果及微转移对肿瘤预后的影响。方法术中淋巴结标本行快速EnvisionTM法检测角蛋白CKAE1/AE3,与常规冰冻病理对淋巴结微转移检出率比较。对14例下咽癌、声门上型喉癌淋巴结标本连续病理切片,比较常规病理检测与Envi-sionTM法对淋巴结微转移检出率。结果快速EnvisionTM法可检出2粒常规冰冻病理不能检出的淋巴结微转移,连续切片应用EnvisionTM法可检出5粒常规病理阴性的淋巴结(5/216)存在微转移灶。结论EnvisionTM法检测角蛋白CKAE1/AE3表达可快速判断头颈部鳞状细胞癌淋巴结微转移,存在多粒淋巴结微转移的患者预后可能较差。

Objective To detect lymph node micro-metastasis and explore the clinical significance of lymph node micrometastasis in head and neck squamous cell carcinoma, Methods 25 lymph nodes taken from head and neck squamous cell carcinoma and frozen in the operations, and 223 lymph nodes taken form 14 cases of hypopharynx cancer or supraglottis cancer and serial sectioned were stained with the Envision^TM system with monoclonal antibody CK（AE1/AE3） and H＆E staining. The results were compared. Results Two micro-metas ＇tasis lymph nodes which were not found by routine frozen section histological staining were found by the quick EnvisionTM system, and five micro-metastasis lymph nodes were detected from 216 H＆E negative lymph nodes by using the immunohistochemisty Envision^TM system. Conclusion The Envision^TM system is effective and rehable and can be used for intra-operative micro-metastasis examination. Patients with two or more micro-metastasis lymph nodes may have a poor prognosis.