粘蛋白基因逆转录聚合酶链反应法检测声门上型喉癌N0颈淋巴结微转移

Detection mucin gene in cervical lymph nodes in supraglottic cancer by reverse transcription polymerase chain reaction

目的 探讨检测颈淋巴结微灶转移的新途径 ,提高声门上型喉癌颈淋巴结微转移的检出率。方法 应用逆转录聚合酶链反应 (reversetranscriptionpolymerasechainreaction ,RT PCR)法 ,对 2 5例临床诊断为N0的声门上型喉癌行颈淋巴结清扫术 ,将取出的淋巴结行常规病理检查 (HE染色 )和粘蛋白 (mucin ,MUC1)基因mRNA检测。结果 2 5例颈淋巴结常规病理检查 (HE染色 )发现 6例有转移 (阳性率为 2 4% )者 ,RT PCR检测也为阳性 ;常规病理检查未发现转移的 19例中 ,RT PCR检测 4例阳性 ,其中 2例为颈淋巴结连续切片检查证实 ,另有 1例术后为转移癌病理证实。RT PCR检测的阳性率为 40 %。结论 MUC1基因RT PCR法检测颈淋巴结微转移较常规病理检查更敏感 。

Objective To investigate the efficacy of discovery of cervical lymph nodes micrometastasis of supraglottic carcinomas by detection of mucin (MUC1) gene. Methods Twenty five supraglottic carcinoma patients with clinically negative lymph nodes were performed neck dissection. MUC1 gene mRNA in these resected lymph nodes was detected by reverse transcription polymerase chain reaction (RT PCR) and histopathological examination to find the potential micrometastasis. Results Of all 93 cervical lymph nodes, micrometastasis were found in 23 nodes of 6 case by histopathaological examination and RT PCR. Four of 19 cases with negative lymph nodes pathologically showed MUC1 gene expression and were identified to have metastasis by clinical recurrence and serial sectioning. Therefore, the rate of detection of micrometastasis by this way was 16%(4/25), higher than that of regular pathologic methods. Conclusion Detection of lymph nodes micrometastasis with RT PCR method was more sensitive than that of regular pathologic methods. It is a valuable method to detect early lymph nodes metastasis.