CK19检测早期宫颈癌淋巴结微转移的临床研究

Clinical research of detecting CK19 in lymph nodes micrometastases of early-stage cervical cancer patients

目的:采用免疫组化法检测常规病理检查无淋巴结转移的早期宫颈癌盆腔淋巴结中CK19的表达,探讨早期宫颈癌微转移的检测率及检测方法,论证检测早期宫颈癌淋巴结微转移的意义。方法:对于入选患者275例按随访结果将有术后复发或远处转移者32例(复发转移率11.6%)纳入病例组,其余无复发或转移者随机的按照下列因素进行配比纳入对照组:治疗、年龄、组织类型、手术病理分期和肿瘤最大径。将选取的患者淋巴结石蜡切片采用免疫组化法检测其中CK19的表达。结果:①病例组477个淋巴结中11个CK19阳性(2.3%),来自32名患者中的8人(25%);对照组425个淋巴结中均无CK19阳性表达(0/425),32名患者中CK19的阳性表达率0。二者之间比较差异有统计学意义;②CK19表达与病理类型及组织的分化程度有相关性(P<0.05)。②微转移与术后复发转移有相关性(P<0.05)。结论:采用免疫组化技术检测淋巴结中CK19表达可检测出早期宫颈癌淋巴结中的微转移,与传统的病理组织学比较,显著提高微转移的检出率。通过本研究证实微转移与术后的复发转移有相关性。

Objective： To evaluate the significance of cytokeratin 19（CK19） expression of pelvic lymph nodes in patients with earlystage cervical cancer without lymph node metastasis by immunohistochemistry. Methods：32 patients with postoperative recurrences and distant metastases from 275 selected patients was patients group and other patients without recurrences and metastases was control group according to the treatment,age,histological type,clinical stage and tumor maximum diameter. CK19 were detected of lymph node paraffin sections in selected patients by immunohistochemistry. Results： ①11 lymph nodes from 477 lymph nodes in patients group were CK19 positive （2.3%） in which CK19 positive rates was 25%; CK19 positive rate of 32 patients in the control group was 0; the difference between two groups was statistically significant.②CK19 expression,the pathological type and tissue differential degree were correlated（P0.05）.③Micrometastases,postoperative recurrence and metastasis were correlated（P0.05）. Conclusion： Compared to traditional pathologichistology,the immunohistochemical stainning detecting CK19 can improve the detection rate of micrometastases in cervical cancer. Confirmed by this study, micrometastases and postoperative recurrence, metastasis were correlated.