N_0期食管癌术后早期复发与淋巴结微转移的相关性研究

A study of correlation between early postoperative relapse with lymph node micrometastasis in patients with N_0 esophageal cancer

目的 探讨病理诊断区域淋巴结无转移癌 (pN0 期 )食管癌根治切除后早期复发与淋巴结微转移的相关性。 方法 应用逆转录聚合酶链反应技术 ,对 4 3例pN0 期食管鳞癌患者 16 6枚根治手术后病理诊断阴性 (pN0 )区域淋巴结的黏蛋白 1(MUC1)基因mRNA进行检测 ,诊断淋巴结微转移。术后 1年内对患者进行随访复查 ,监测肿瘤的早期复发 ,比较 pN0 淋巴结MUC1基因mRNA表达与否的肿瘤患者复发率差别。 结果 18例患者 (42 % )的 2 6枚 (15 7% )淋巴结检测到MUC1基因mRNA的表达 ,诊断为淋巴结微转移 ,TNM分期由Ⅰ～ⅡA 期上调为ⅡB～Ⅲ期 ;12例患者肿瘤复发 ,其中淋巴结微转移者 9例 ,无转移者 3例 ,两者比较 ,差异有显著性 (校正 χ2 =5 7,P <0 0 5 )。 结论 pN0 期患者手术后肿瘤的早期复发与淋巴结微转移有关。

Objective To explore the correlation between early postoperative tumor relapse with lymph node micrometastasis in the patients with pN_0 esophageal cancer. Methods Using reverse transcriptase-polymerase chain reaction (RT-PCR),one hundred and sixty-six regional lymph nodes obtained from forty-three patients with esophagus cancer without invasion of the tumor confirmed by histopathologic analysis (pN_0) were studied for further detecting mRNA of Mucin1 (MUC1) gene and determining nodal micrometastasis. All the patients underwent radical resection and regional lymph node dissection. Patients were followed up for one year to detect early tumor relapse. Difference in relapse was compared by χ 2 test. Results MUC1 mRNA expression was identified for twenty-six lymph nodes (15.7%),in eighteen patients (42%) who were diagnosed as having nodal micrometastasis. TNM staging for these patients was up-regulated from stagesⅠ-Ⅱ_A to stages Ⅱ_B-Ⅲ. Relapse disease was found in nine patients with lymph nodes micrometastasis and three patients without nodal micrometastasis ( P <0.05). Conclusion Early tumor relapse after radical surgery in the patients with pN_0 esophageal cancer might be correlated with nodal micrometastasis.