应用流式细胞术检测口腔鳞癌颈淋巴结隐匿转移

Application of flow cytometry to detect occult metastasis in cervical lymph nodes of oral squamous cell carcinoma

目的:应用流式细胞术检测cN0口腔鳞癌颈淋巴结隐匿转移,并与半连续切片HE染色法对比,探讨其临床价值。方法:取33例cN0口腔鳞癌患者44侧颈清扫术后颈部淋巴结标本共470枚,-70℃冰箱保存,其中61枚较大淋巴结纵向剖开,一半行流式细胞术检测,另一半行间隔400μm的半连续切片HE染色检查;较小淋巴结按区进行流式细胞术检测。计算2种检测方法的阳性淋巴结检出率,采用SPSS11.0软件包行χ2检验,比较其统计学差异,并对颈淋巴结的隐匿转移率与肿瘤T分期、病理分级、肿瘤发生部位三因素的相关性进行统计学分析。结果:流式细胞术检测全颈淋巴结的隐匿转移阳性率为3.2%(15/470)～3.8%(18/470)。流式细胞术和HE染色法检测较大淋巴结的隐匿转移阳性率分别是21.3%和6.6%,差异具有统计学意义(χ2=7.11,P<0.01)。淋巴结的隐匿转移率与肿瘤T分期、病理分级、肿瘤发生部位均无相关关系(P>0.05)。结论:流式细胞术可以提高颈淋巴结隐匿转移的检出率,与半连续切片HE染色法有差异,可以作为口腔鳞癌颈淋巴结隐匿转移的检测方法。隐匿转移与肿瘤原发灶部位、病理分级、临床T分期无相关关系。

PURPOSE： To detect the cervical lymph nodes occult metastasis of oral squamous cell carcinoma, using of flow cytometry and compare with senti-continuous section HE staining method,and to evaluate the significance of this technology. METHODS： Cervical lymph nodes specimens from cNo oral squamous cell carcinoma patients were obtained, and stored in -70℃. Bigger lymph nodes were split in the long wise, one half was detected by flow cytometry, and 400um semi-continuous section using HE staining was carried on the other half. Smaller lymph nodes were detected by flow cytometry according to the section. Chi-square test was performed for the statistical analysis using SPSS11.0 Software package. RESULTS： The positive rate of all cervical lymph nodes detected by flow cytometry was 3.2%（15/470）-3.8% （18/470）. The positive rate of occult metastasis of bigger lymph nodes detected by flow cytometry and HE staining were 21.3% and 6.6%, and the difference was statistically significant （X^ 2=7-11 ,P〈0.01）.There was no correlation between occuh metastasis of lymph nodes and clinical tumor staging, pathological grading, and primary tumors sites （P〉0.05）. CONCLUSIONS： Flow cytometry can improve the detection of lymph nodes occult metastasis, compared with semicontinuous section HE staining, so it can be used as a method for detecting cervical lymph nodes occult metastasis of oral squamous cell carcinoma. There is no correlation between occult metastasis and tumors sites, pathological grading, and clinical tumor staging.Supported by Natural Science Foundation of Liaoning Province（Grant No. 20042090）.