食管癌淋巴结隐匿性转移的基因诊断

Genetic diagnosis of occult metastasis of lymph node in patients with esophageal carcinoma

目的 :探讨食管癌淋巴结隐匿性转移的基因诊断方法。方法 :应用逆转录聚合酶链反应法 (RT PCR) ,检测阴性对照组及阳性对照组淋巴结MUC1基因mRNA表达 ,计算特异度及灵敏度 ;检测食管鳞癌手术后病理诊断阴性的区域淋巴结 (pN0 )中MUC1基因mRNA表达 ,诊断淋巴结隐匿性转移。结果 :阴性对照组 30个标本 (食管良性疾病区域淋巴结 )均无MUC1基因mRNA表达 ,特异度为 10 0 % ;阳性对照组 30个标本 (食管鳞癌病理证实有转移癌的区域淋巴结 )中 2 5枚检测到MUC1mRNA的表达 ,灵敏度为 83%。实验组 30例 pN0 食管癌的87枚区域淋巴结中 ,其中 8例病人的 9枚淋巴结检测到MUC1mRNA表达 (检出率 10 .3% )。结论 :应用RT PCR法检测食管癌区域淋巴结中MUC1基因mRNA的表达可以诊断淋巴结隐匿性转移。

Purpose:To investigate genetically a diagnostic method of occult metastasis of lymph node in patients with squamous cell carcinoma of the esophagus.Methods:Using assays of reverse transcriptase polymerase chain reaction technique (RT PCR), MUC1 gene mRNA in thirty negative and thirty positive control lymph nodes was detected to evaluate diagnostic sensitivity and specificity. Eighty seven negative regional lymph nodes by conventional histologic examination (pN 0 ) from thirty patients with esophageal carcinoma were studied to detect MUC1 gene mRNA to diagnose lymph node occult metastasis.Results:MUC1 mRNA was not identified in any specimen of negative control group (specificity =100%); MUC1 mRNA was identified in twenty five of positive control specimen (sensitivity =83%). MUC1mRNA was identified in nine lymph nodes (10.3%) from eight patients with pN 0 esophageal carcinoma. Conclusions: Nodal occult metastasis could be diagnosed by the detection of expression of MUC1mRNA of lymph node in patients with pN 0 esophageal carcinoma.