实时荧光定量PCR检测胃癌淋巴结微转移及其临床意义

Identify Micrometastasis in Lymph Nodes of Gastric Cancer Use qRT-PCR Assay and Evaluate The Clinical Significance of Micrometastasis

目的使用实时荧光定量PCR(qRT-PCR)法检测胃癌淋巴结的微转移情况,并探讨微转移的临床意义。方法收集我院2010年1～6月期间40例行胃癌根治术切除的281枚和10例行胃十二指肠溃疡手术切除的39枚,共计320枚淋巴结标本,以CEA、CK-19和CK-20为引物进行qRT-PCR检测其微转移情况,并分析微转移的临床病理特点。结果 40例胃癌患者中有28例(70.00%)、31枚(15.35%,31/202)淋巴结检测出有微转移。10例胃溃疡的39枚淋巴结标本,HE染色检测和qRT-PCR检测均为阴性。淋巴结微转移的阳性率与肿瘤分化程度、浸润深度和临床分期有关(P<0.05)。结论 qRT-PCR是检测胃癌淋巴结微转移敏感且特异的方法,对胃癌临床分期、判断预后以及治疗方案选择具有重要意义。

Objective To identify micrometastasis in regional lymph nodes of gastric cancer by quantitative real-time reverse transcription-PCR（qRT-PCR） assay and to evaluate the clinical significance of micrometastasis.Methods To study 320 lymph nodes collected from January 2010 to June 2010,281 of which were from 40 patients with gastric cancer who had undergone a standard gastrectomy with lymphadenectomy,and other 39 of which were from 10 patients with gastroduodenal ulcer.Made CEA,CK-19,and CK-20 as primers,and used qRT-PCR assay in addition to hematoxylin and eosin staining to detect the micrometastasis,and to analyze the clinicopathologic characteristics.Results Totally,micrometastasis were detected by qRT-PCR assay in 31（15.34%,31/202） lymph nodes of 28（70.00%,28/40） patients.Thirty-nine lymph nodes from 10 patients with gastroduodenal ulcer were negative by qRT-PCR and HE staining.The degree of differentiation,depth of gastric mural invasion,and clinical stage had statistically significant correlation with the incidence of lymph node micrometastasis（P0.05）.Conclusions qRT-PCR assay is a sensitive and specic method to detect lymph node micrometastasis in gastric cancer patients,and it has importantly clinical significance in evaluating clinical staging,prognosis and treatment prescription.