舌癌颈淋巴结微转移灶的免疫组化检测

目的:探讨免疫组织化学S-P微波法对阴性淋巴结微转移灶的检出率。方法:采用S-P微波法,对30例舌鳞状细胞癌患者既往报告为阴性的152个淋巴结的石蜡标本再作切片,并作免疫组织化学染色。取阳性淋巴结作为对照。结果:30例患者152个阴性淋巴结,经CK(AE1/AE3)单克隆抗体标记后,在4例(1313%)患者中共7个淋巴结(416%)内CK(AE1/AE3)单克隆抗体呈阳性反应。癌细胞呈单个或呈簇状散在于淋巴结内,淋巴结结构完好。检出的4例患者,高分化及低分化鳞状细胞癌各2例,其中2例术前已发现颈部有肿大淋巴结,7个微转移之淋巴结中,颌下区2,颈深上4,颈深中1。正常淋巴结呈阴性反应。结论:舌癌患者的阴性淋巴结中,仍有一定数量的微转移灶发生,采用免疫组化的方法,对发现与诊断微转移灶具有一定的可靠性和应用前景。

Immunohistochemical Detection of Micrometastases in Cervical Lymph Nodes from Squamous Cell Carcinoma of Tongue in Neck Dissection Specimens

OBJECTIVE: The purpose of this study was to explore a feasible method to detect the micrometastases. METHODS: Totally 152 cases of negative cervical lymph nodes (CLNs) from 30 patients with squamous cell carcinoma in tongue were included in this study. The HE-stained slices of the CLN were reexamined by two experienced pathologists and, conformed that no carcinoma cells were found. Two slices were made from each paraffin specimen and, the slices were stained with the microwave immunohistochemical technique with monoclonal antibody CK (AE1/AE3) (DAKO Co. Denmark, 1:100). RESULTS: Among these 152 cases 7 (4.6%) positive lymph nodes were found in 4(13.3%) patients, and CLN metastases were found in all the patients before the surgical treatment. Most of the micro-metastatic nodes appeared in the upper deep cervical area, except that one of them was found in the submandibular triangle. CONCLUSION: The results suggest that micrometastases frequently occurred in negative lymph nodes. The present method may be useful in detecting the micrometastases of lymph nodes and in evaluating clinical stages of patients with oral cancers.