免疫组化法和RT-PCR法检测胃癌淋巴结微转移

Detection of Lymph Node Micrometastases in Gastric Carcinoma by Immunohistochemical and RT-PCR Methods

目的 :应用免疫组化方法和RT PCR方法检测常规病理检查淋巴结阴性胃癌之淋巴结微转移 ,比较两种检测方法的敏感性同时探讨检测胃癌淋巴结微转移的临床意义。方法 :采用CEA单克隆抗体免疫组织化学方法和CEAmRNART PCR方法分别检测 11例常规病理检查淋巴结阴性胃癌的 2 0 5枚淋巴结。结果 :CEA单克隆抗体免疫组织化学法检出 18枚 (8.8% )微转移淋巴结 ,而CEAmRNART PCR法共检出 46枚 (2 2 .4% )微转移淋巴结 ,两者比较差异显著 (P <0 .0 1)。 11例患者中有 6例存在淋巴结微转移 ,此 6例患者的重新TNM分期均有所上升。随访中发现有 2例微转移阳性患者分别于根治术后第 6、9个月出现复发。结论 :应用CEA单克隆抗体免疫组织化学方法或CEAmRNART PCR法可以检测出常规病理检查遗漏的胃癌淋巴结微转移灶。而且RT PCR法检测胃癌淋巴结微转移较免疫组织化学法更为敏感。检测常规病理检查淋巴结阴性胃癌的淋巴结微转移 ,有助于临床准确分期 ,判断预后及指导治疗。

Objective: To detect lymph node micrometastases, in patients with histologically node negative gastric carcinoma and explore the clinical significance of lymph node micrometastases in gastric carcinoma.Methods:A total of 205 lymph nodes from 11 patients,with histologically node negative gastric carcinoma, were detected by immunostaining with monoclonal antibody CEA and CEA mRNA RT PCR for micrometastases respectively.Results:18 lymph nodes (8.8%) were found to have micrometastases by immunostaining with CEA antibody and 46 (22.4%) by CEA mRNA RT PCR.The two rates were significantly different( P &lt;0.01).The TNM classification of 6 patients with lymph node micrometastases was upstaged. In the follow up, two cases with lymph node micrometastases recurred in 6 months and nine months after radical resection respectively.Conclusion:Lymph node micrometastases can be detected by immunostaining with CEA antibody or CEA mRNA RT PCR. The RT PCR assay was more sensitive.The detection of lymph node micrometastases has an important significance in determining the clinical staging and prognosis and can a direct clinical therapy of gastric carcinoma.