DNA倍体上皮细胞标志物广谱细胞角蛋白AE1/AE3联合检测子宫内膜癌淋巴结微转移的意义

Significance of DNA ploidy and CK(AE1/AE3) combined detection for lymph node micrometastasis in endometrial carcinoma

目的在子宫内膜癌转移阴性淋巴结中检测DNA倍体和上皮细胞标志物广谱细胞角蛋白[CK(AE1/AE3)],分析淋巴结微转移与上述指标的关系,探讨上述指标检测子宫内膜癌淋巴结微转移的可行性及临床价值。方法收集2013年1月至2016年12月接受手术治疗的子宫内膜癌患者35例,共收集427枚转移阴性淋巴结,分别用全自动细胞DNA图像分析系统检测DNA倍体及免疫组织化学法检测AE1/AE3。结果 (1)在427枚转移阴性淋巴结中,手术-病理分期、组织学分级、病理类型、肌层浸润深度等组内进行比较,上述指标阳性表达率差异有统计学意义(P<0.05)。(2)通过比较无转移组淋巴结与转移组阴性淋巴结发现,2组阴性淋巴结中DNA异倍体表达率、AE1/AE3阳性表达率差异有统计学意义(P<0.05)。(3)在427枚转移阴性淋巴结中,43枚(10.1%)DNA异倍体表达阳性,39枚(9.1%)AE1/AE3表达阳性,DNA倍体与AE1/AE3在转移阴性淋巴结中的表达差异无统计学意义(P>0.05),两者联合检测较单一指标检测,可显著提高淋巴结的微转移检出率(P<0.05)。结论在转移组阴性淋巴结较无转移组淋巴结中,可能更容易找到早期发生的微转移灶。在转移阴性淋巴结中,DNA异倍体与AE1/AE3的阳性表达差异无统计学意义,两者联合检测有助于检测子宫内膜癌淋巴结微转移。

Objective To detect the DNA ploidy and CK （AE1/AE3） in metastasis-negative lymph nodes in en- dometrial carcinoma,determine their relationship with lymph node micrometastasis, and to investigate the feasibility and clinical value of theseindexes for identify-ing lymph node micrometastasis in endometrial carcinoma.Methods Thirty-five patients with endometrial carcinoma, who underwent surgical treatment between January 2013 and December 2016, were included in the study. A total of 427 metastasis-negative lymph nodes were collected. The DNA ploidy was determined by a full-automatic cell DNA image analysis system, and AE1/AE3 was examined by immunohisto- chemistry. Results ①Among the 427 metastasis-negative lymph nodes, the surgical-pathological stage, histological grade, pathological type, and myometrium invasion depth were compared within-group. There were statistically signifi- cant differences in the positive expression rate of the indexes （P〈0.05）. ②By comparingthe lymph nodes in the non- metastatic group with the metastasis-negative group, there were statistically significant differences in the expression rate of DNA aneuploidy and positive expression rate of AE1/AE between the two groups of negative lymph nodes （P〈 0.05）. ③Among the 427 metastasis-negative lymph nodes, there were 43 cases of positive DNA aneuploidy （10.1%）, and 39 of positive AE1/AE3 （9.1%）. There were no statistical differences in the expression of DNA aneuploidy and AE1/AE3 in the metastasis-negative lymph nodes （P〉0.05）. The combined detection could significantly improve the detection rate of lymph node micrometastasis compared with the single index detection （P〈0.05）. Conclusion It may be easier to find early-onset micrometastasis in metastasis-negative lymph nodes than in non-metastatic lymph nodes. In metastasis-negative lymph nodes, there is no significant difference between the positive expression of DNA aneuploidy and AE1/AE3. The combination of both favors the detection of micrometastasis in endometrial carcinoma.