应用RT-PCR检测乳腺癌前哨淋巴结微转移的研究

目的评价前哨淋巴结（SLN）活检及其微转移检测临床意义。方法本组46例原发性乳腺癌患者，应用美蓝进行前哨淋巴结定位和活检，随后行腋窝淋巴结清扫（ALND），行SLN、腋淋巴结（ALN）中CK19的RT-PCR检查。结果46例乳腺癌患者中，41例检测到SLN（89．1％），SLN的成功定位活检与肿瘤大小有关。对上述41例的SLN的常规病理检查的敏感性是75％，准确性是90．2％，假阴性25％。在行RT-PCR检查中，敏感性是96％，准确性是97．6％，假阴性4％。结论RT—PCR法较常规病理更为敏感，通过SLN定位和RT-PCR的联合应用，可明显提高乳腺癌淋巴结微转移的检出率。

Detection of micrometastasis in sentinel lymph nodes of breast cancer using RT-PCR

Objective To avaluate the clinical significance of sentinel lymph nod(SLN)detection and detecting SLN micrometastases in breast cancer.Methods 46 cases of primary mammay carcinoma patients were injected methylene blue and taken SLND,then ALN was eliminated.The RT-PCR of SLN and ALN were detected of CK19.Results Lymphatic mapping was successful in identifying the SLN in 41/46(89.1%) cases of nodes.It was related of the tumor size,The sensitivity,accuracy and false-nedative of routine examination of pathology for SLNs was 75% and 90.2% and 25% respectively.the sensitivity,accuracy and false-nedative of CK19 RT-PCR for SLNs was 96%,97.6% and 4% respectively.Conclusion The RT-PCR is more sensitive then routine pathological method for the detection of micrometastases.The combined utilization of locating SLN and RT-PCR can greatly enhance the efficiency of micrometastases detection in axillary lymph nodes.