定量RT-PCR法检测乳腺癌前哨淋巴结CK19的研究

目的探讨定量RT-PCR法检测细胞角蛋白(CK19)在乳腺癌前哨淋巴结(SLN)中的表达,提高前哨淋巴结活检中微转移的检出率。方法采用常规病理检查法(HE染色)和定量RT-PCR法检测了40例乳腺癌患者SLN的CK19的表达量,同时选取10例来源于胃肠道的良性病变淋巴结作为定量RT-PCR检测的对照组。结果CK19在良性病变的淋巴结中没有表达。常规病理检查的敏感度为42.9%(9/21),假阴性为57.1%(12/21),准确率为70.0%(28/40)。定量RT-PCR法检测出常规病理未检出的微小转移病例12例,敏感度为95.2%(20/21),假阴性为4.8%(1/21),准确率为97.5%(39/40)。结论前哨淋巴结活检可有效判断乳腺癌腋淋巴结转移状态,应用定量RT-PCR法检测CK19在SLN中的表达,可提高敏感度及准确率。

Detection of Cytokeratin 19 in Sentinel Lymph Nodes of Breast Cancer by Using Quantitative RT-PCR

Objective The purpose of this study is to determine the expression level of CK19 in sentinel lymph nodes(SLN)of breast cancer by quantitative RT-PCR,and to improve the detection rate of micrometastasis in breast cancer.Methods SLN of 40 patients with breast cancer were performed histological analysis by hematoxylin and eosin staining,and the expression level of CK19 in these nodes were determined by quantitative RT-PCR.10 matched control lymph nodes obtained the stomach and intestines with benign pathological changes were used as control for the quantitative RT-PCR.Results There was no expression of CK19 in the lymph nodes with benign gastrointestinal lesion.The sensitivity of the histological diagnosis by hematoxylin and eosin staining was 42.9%(9/21),with a false-negative rate of 57.1%(12/21),and accuracy of 70.0%(28/40).Quantitative RT-PCR detected 12 positive cases that were not detected in the histological diagnosis,with a sensitivity of 95.2%(20/21),false-negative rate of 4.8%(1/21)and accuracy of 97.5%(39/40).Conclusion Measuring the expression level of CK19 in the sentinel lymphode of breast cancer by quantitative RT-PCR can improve the sensitivity and accuracy of detecting axillary lymph node metastasis.