乳腺癌前哨淋巴结中hMAM的表达及其临床意义

Expression and significance of hMAM in sentinel lymph node of breast cancer

目的探讨乳腺癌前哨淋巴结(SLN)组织中人乳腺珠蛋白(hMAM)的表达及其临床意义。方法 32例可手术的原发性乳腺癌患者,在乳腺癌根治性手术中均行肿块周围或乳晕周围注射亚甲蓝成功定位SLN,按常规行腋窝淋巴结清扫,术后对SLN和非SLN行常规病理学检查,并进一步采用RT-PCR和Western Blot检测SLN冷冻组织中hMAM的表达。结果 32例SLN常规病理检查结果6例阳性SLN,阳性率为18.75%,1例假阴性,假阴性率为14.28%。RT-PCR和Western Blot检测hMAM,阳性SLN分别为12例和9例,阳性率分别为37.50%和28.13%,无假阴性。两者与病理检查结果相比差异均有显著性(P<0.05)。结论 SLN定位后检测SLN中hMAMmRNA的阳性表达,相对于SLN定位后仅行常规病理检查,明显提高了乳腺癌阳性SLN的准确率,降低假阴性率。故hMAMmRNA可单独作为标志物来检测乳腺癌SLN微转移。

Objective To detect the expression of hMAM in sentinel lymph node（SLN） of breast cancer,and to evaluate the clinical significance.Methods The SLN of 32 patients with breast cancer was successfully detected with methylene blue,and both SLN and non-SLN were examined by hematoxylin and cosin staining（HE staining）.Then SLN were examined by RT-PCR and Western Blot for the expression of hMAM.Results Detection rate of SLN metastases was 18.75% by HE staining,37.50% for hMAMmRNA by applying RT-PCR and 28.13% for hMAM by applying Western Blot.There was a significant difference between RT-PCR or Western Blot methods and routine pathological examination（P0.05） for the detection rate of SLN metastases.Conclusions Utilization of RT-PCR instead of histopathological examination to detect the expression of hMAMmRNA in SLN can greatly enhance the accuracy diagnose rate of micrometastases of the SLN in breast cancer.hMAMmRNA may be potential tumor marker for detecting micrometastasis of SLN breast cancer.