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目的 探讨检测颈淋巴结微灶转移的新途径 ,提高声门上型喉癌颈淋巴结微转移的检出率。方法 应用逆转录聚合酶链反应 (reversetranscriptionpolymerasechainreaction ,RT PCR)法 ,对 2 5例临床诊断为N0的声门上型喉癌行颈淋巴结清扫术 ,将取出的淋巴结行常规病理检查 (HE染色 )和粘蛋白 (mucin ,MUC1)基因mRNA检测。结果 2 5例颈淋巴结常规病理检查 (HE染色 )发现 6例有转移 (阳性率为 2 4% )者 ,RT PCR检测也为阳性 ;常规病理检查未发现转移的 19例中 ,RT PCR检测 4例阳性 ,其中 2例为颈淋巴结连续切片检查证实 ,另有 1例术后为转移癌病理证实。RT PCR检测的阳性率为 40 %。结论 MUC1基因RT PCR法检测颈淋巴结微转移较常规病理检查更敏感 ,可为临床提供一种有价值的方法
Objective To explore a new way to detect cervical lymph node micrometastasis and improve the detection rate of cervical lymph node micrometastasis in supraglottic laryngeal cancer. Methods Twenty - five cases of supraglottic laryngeal carcinoma with clinical diagnosis of N0 were treated with cervical lymph node dissection by reverse transcriptase polymerase chain reaction (RT PCR). Lymph nodes were removed by routine pathological examination (HE staining) and Mucin (MUC1) gene mRNA detection. Results Twenty-five patients with metastasis (positive rate was 24%) were found by routine pathological examination (HE staining) in 25 cases of cervical lymph nodes. The positive rate was also detected by RT-PCR. In the 19 cases without metastasis by routine pathological examination, Cases were positive, including 2 cases of cervical lymph nodes confirmed by serial biopsy, and another case of metastatic carcinoma of the pathology confirmed. The positive rate of RT PCR detection was 40%. Conclusion MUC1 gene RT PCR method is more sensitive than routine pathological examination for cervical lymph node micrometastasis and may provide a valuable clinical method