细胞角蛋白20检测对判断大肠癌淋巴结微转移的临床意义

目的研究细胞角蛋白20（CK20）的表达对判定大肠癌淋巴结微转移的意义。方法对47例大肠癌根治术患者的331枚淋巴结进行CK20免疫组织化学染色检查，判定是否有微转移的存在，并对所有患者进行随访。结果CK20免疫组织化学染色与普通病理染色对大肠癌淋巴结转移的检出率差异有统计学意义（P〈0．01）。前哨淋巴结及同组患者未进行前哨淋巴结定位的淋巴结两组微转移的检出率差异有统计学意义（P〈0．05）。有淋巴结微转移的患者术后3年死亡率明显高于无淋巴结微转移者（P〈0．05）。结论大肠癌淋巴结微转移是影响患者预后的独立危险因素。CK20免疫组织化学染色可作为临床判断大肠癌淋巴结微转移的有效方法。

Significance of CK20 in micrometastasis of lymph node of colorectal cancer

Objective To study the significance of cytokeratin 20(CK20)in micrometastasis of lymph node of colorectal cancer.Methods The 331 lymph nodes in 47 cases with colorectal cancer by radical resection were collected from 2000 to 2007 in our Hospital.They were carried out CK20 immunohistochemical staining to determine the existence of micrometastasis,and all patients were followed up.Results The tumor cells in lymph nodes of colorectal cancer were found by CK20 immunohistochemistry and routine hematoxylin-eosin staining separately,but the positive rate had significant difference(P＜0.01).By CK20 immunohistochemistry,the micrometastasis positive rate was found significantly different between the sentinel lymph nodes and all the lymph nodes (P＜0.05).3-year mortality for the patients with lymph node micrometastasis was significantly higher than those without lymph node micrometastasis (P＜0.05).Conclusion The lymph node micrometastasis was an independent risk factor of influencing the survival time of the colorectal cancer patients.Examining the expression of CK20 by immunohistochemistry is an effective way of detecting colorectal cancer lymph node micrometastasis.