pNO期胃腺癌淋巴结微转移的检测及临床意义的研究

发布时间：2018-12-05 18:16

【摘要】：目的选择CK20作为目标检测物,使用IHC和RT-PCR法共同检测常规病理方法诊断为pNO期的胃腺癌患者淋巴结,统计分析胃腺癌淋巴结微转移与术前可获得的临床病理因素的关系,探索同时使用免疫组化法和RT-PCR法进行胃腺癌淋巴结微转移检测,探讨胃腺癌淋巴结微转移的临床意义。方法选取2013年1月到2016年6月期间于宁夏回族自治区人民医院接受手术的pNO期胃癌患者32例,收集术后淋巴结组织蜡块共158个,所有淋巴结均经切片HE染色检查,病理诊断为NO。应用免疫组织化学染色法和RT-PCR法联合检查其中CK20的表达,进行统计,分析胃腺癌淋巴结微转移与患者性别、年龄、肿瘤部位、肿瘤大小、浸润深度及分化程度等术前可获得的临床病理资料的关系。结果经免疫组织化学染色法检测出7例患者,共14个淋巴结CK20阳性,阳性率为21.87%;经RT-PCR法检测出10例患者,共23个淋巴结中CK20mRNA阳性,阳性率为31.25%。两种方法检测结果均为阳性的患者有6例,RT-PCR法结果呈阳性而免疫组化法结果呈阴性的患者有4例,免疫组化法结果阳性而RT-PCR法结果阴性患者1例。两种检测方法共检出11例患者存在微转移。不同分化程度的胃腺癌淋巴结微转移之间差异有统计学意义(P0.05)。淋巴结微转移与胃腺癌的分化程度有关,低分化胃腺癌较中-高分化胃腺癌容易出现微转移,淋巴结微转移与胃腺癌患者的年龄、性别、肿瘤部位,肿瘤大小及浸润深度无关。结论胃腺癌淋巴结微转移与分化程度有关,低分化胃腺癌较中-高分化胃腺癌容易出现微转移。免疫组化法和RT-PCR法联合检测胃腺癌淋巴结微转移有提高微转移检出率的趋势。
[Abstract]:Objective to select CK20 as the target detection material and to detect lymph nodes in patients with gastric adenocarcinoma diagnosed as pNO by IHC and RT-PCR, and to analyze the relationship between lymph node micrometastasis of gastric adenocarcinoma and clinicopathological factors available before operation. To explore the clinical significance of the detection of lymph node micrometastasis in gastric adenocarcinoma by immunohistochemical method and RT-PCR method. Methods from January 2013 to June 2016, 32 patients with pNO stage gastric cancer underwent operation in Ningxia Hui Autonomous region people's Hospital. A total of 158 lymph nodes were collected. All lymph nodes were examined by HE staining. Pathological diagnosis of NO. Immunohistochemical staining method and RT-PCR method were used to detect the expression of CK20 and to analyze the relationship between lymph node micrometastasis and sex, age, tumor location, tumor size. The relationship between the depth of invasion and the degree of differentiation. Results the positive rate of CK20 was 21.87 in 14 lymph nodes of 7 cases detected by immunohistochemical staining and 31.25% in 23 lymph nodes of 10 cases detected by RT-PCR method. There were 6 cases with positive results by both methods, 4 cases with positive results by RT-PCR and negative results with immunohistochemistry, and 1 case with positive results by immunohistochemical method and negative results with RT-PCR method. Micrometastasis was detected in 11 patients by two methods. The difference of lymph node micrometastasis of gastric adenocarcinoma with different differentiation degree was statistically significant (P0.05). Lymph node micrometastasis was related to the differentiation degree of gastric adenocarcinoma. The micrometastasis was more likely to occur in poorly differentiated gastric adenocarcinoma than that in moderately well differentiated gastric adenocarcinoma. There was no correlation between lymph node micrometastasis and age, sex, tumor location, tumor size and depth of invasion in patients with gastric adenocarcinoma. Conclusion lymph node micrometastasis is related to the degree of differentiation in gastric adenocarcinoma, and micrometastasis is more likely in poorly differentiated gastric adenocarcinoma than in moderately well differentiated gastric adenocarcinoma. The detection of lymph node micrometastasis in gastric adenocarcinoma by immunohistochemical method and RT-PCR method has a tendency to increase the detection rate of micrometastasis.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R735.2

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