细胞角蛋白19基因诊断淋巴结微转移癌灶的意义

Study on Detecting Micrometastasis in Lymph Nodes by Using CK19 RT-PCR

目的研究淋巴结转移情况以判断肿瘤预后，指导综合治疗。方法应用细胞角蛋白19（cyto－keratin19，CK19）RT－PCR方法对上皮性肿瘤及淋巴结进行CK19mRNA检测。结果5例正常淋巴结无CK19mRNA表达；15例乳腺癌、10例胃癌、11例大肠癌均表达CK19mRNA；82个淋巴结中，组织学检查11个有肿瘤转移，其CK19RT－PCR也为阳性，其余71个无肿瘤浸润淋巴结，经CK19RT－PCR发现16个表达CK19mRNA。结论CK19RT－PCR方法提高了淋巴结转移的检出率，在上皮性肿瘤患者的其它部位（外周血、骨髓）微转移癌灶的检测中有推广应用价值。

Objective Studing on lymph node metastases to judge the prognosis of tumor and direct the adjuvant therapy. MethodsWe detected the expression of CK19mRNA inepitheliae cancer and lymph nodes by reverse - transcription polymerase chainreaction(RT - PCR). Results CK19mRNA was detected in all 15 breast cancer, 10 gastric cancer and 11 colorectal cancer, but not in 5 control lymph nodes. Of 82 lymph nodes analysed by HE staining and CK19RT- PCR, 11 lymph nodes were found to have metastases by both methods. Of the remaining 71 nodes that were diagnosed to be devoid of metastasis by HE staining, 16 were found to have metastases by using CK19 RT - PCR. There were micrometastases in those lymph nodes. Conclusion CK19 RT - PCR is a more sensitive method than histology study for the detection of micrometastases in lymph nodes. This new method can also be used in peripheral blood and bone marrow to detect micrometastases.