RT-PCR检测胃癌无转移淋巴结(PN0)微转移的临床意义

Clinical significance of detecting micrometastasis in lymph nodes from untransferred gastric cancers by RT-PCR

目的 从分子水平对胃癌淋巴结微转移进行诊断分级 ,评价胃癌临床分期及预后。方法 应用RT PCR方法 ,以细胞角蛋白 18(CK18)为标志基因 ,检测对照组良性病变淋巴结 2 0枚 ,胃癌组无转移淋巴结 (PN0 ) 199枚。结果 ①对照组良性病变淋巴结中无CK18mRNA表达 ,与病理符合率 10 0 %。胃癌组病理检查为阴性的 199枚淋巴结中有CK18mRNA阳性表达 34枚 ,阳性率 17.1%。②胃癌淋巴结微转移 (LMM)与肿瘤临床病理参数浸润 (T)呈正相关。结论 用RT PCR法检测胃癌无转移淋巴结CK18mRNA是发现胃癌淋巴结微转移敏感而特异的方法 ,对胃癌临床分期及指导治疗有较大的临床意义。

Objective To evaluate clinical staging and prognosis of lymph nodes micrometastasis in gastric cancer from molecular level.Methods Cytokeratin 18 as marker gene,detecting CK18 expression by reverse transcription-polymerase chain reaction (RT-PCR) in 20 lymph nodes with control groups and 199 lymph nodes with PN 0.Results ①The negative expression of CK18mRNA with control groups,coincidence rate was 100%,compared with those results obtained with pathology.The positive expression of CK18mRNA in 34 of 199 lymph nodes with PN 0 by pathology diagnosis in gastric cancer groups.The positive rate was 17.1%. ②LMM and T of pathology parameters of tumor clinic were positive correlation.Conclusion Detecting CK18mRNA by RT-PCR is more sensitive and specific than rountine histology for diagnosing lymph nodes micrometastasis in gastric cancer,and it has importantly clinical significance in evaluating clinical staging and guiding treatment.