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目的 :探讨Ⅰa期非小细胞肺癌 (NSCLC)手术后早期转移与纵隔淋巴结隐匿性微转移的相关性。方法 :应用RT PCR技术 ,检测 5 0例Ⅰa期NSCLC患者纵隔淋巴结中MUC1基因mRNA的表达 ,诊断纵隔淋巴结隐匿性微转移 ;手术后 12个月内对患者至少复查一次 ,包括胸、脑CT扫描 ,肝、肾上腺B超和骨ECT检查 ,监测早期转移。根据有否淋巴结隐匿性微转移 ,将患者分为两组。χ2 检验比较两组早期转移率的差别 ,计算两组早期转移概率的优势比 (OR值 )。结果 :16例诊断为纵隔淋巴结隐匿性微转移 ,占全部患者的 32 .0 %。纵隔淋巴结隐匿性微转移者的早期转移率 (31.2 5 % )高于淋巴结微转移阴性者 (5 .88% ) ,差别具有显著性 (P <0 .0 5 )。有纵隔淋巴结隐匿性微转移者早期转移的概率是后者的 7倍 (OR =7.2 7)。结论 :Ⅰa期NSCLC患者手术后早期转移与纵隔淋巴结隐匿性微转移有关
Objective: To investigate the correlation between early metastasis of stage Ⅰ a non-small cell lung cancer (NSCLC) and occult micrometastases of mediastinal lymph nodes. Methods: RT-PCR was used to detect the mRNA expression of MUC1 in mediastinal lymph nodes of 50 stage Ⅰa NSCLC patients and to diagnose the occult micrometastases of mediastinal lymph nodes. At least 12 months after operation, the patients were reviewed at least once, including chest CT scan , Liver, adrenal B ultrasound and bone ECT examination, monitoring of early metastasis. Patients were divided into two groups according to whether there were occult micrometastases in lymph nodes. Chi-square test was used to compare the difference of early metastasis rates between the two groups, and the odds ratio (OR) of early metastasis probability was calculated. Results: 16 cases were diagnosed as occult micrometastases of mediastinal lymph nodes, accounting for 32.0% of all patients. The rate of early metastasis (31.2 5%) in patients with occult micrometastases of mediastinal lymph nodes was significantly higher than that in those with negative micrometastases (5.88%) (P <0.05). The probability of early metastasis in patients with occult micrometastases with mediastinal lymph nodes was seven-fold (OR = 7.27). Conclusions: The early postoperative metastasis of stage Ⅰa NSCLC is related to the occult micrometastasis of mediastinal lymph nodes