卵巢癌淋巴结微转移的检测及临床意义

目的：检查卵巢癌患者淋巴结内有无微小转移。方法：33例原发性卵巢癌共获淋巴结187个，将石蜡包埋癌组织块和淋巴结连续切片2张，分别作H－E染色及用抗细胞角蛋白（cytokeratin,CK）单克隆抗体进行免疫组化染色。结果：34例中33例原发灶呈CK阳性反应，CK染色发现33例187例淋巴结中12例（36.4%）31个淋巴结（16.6%）CK阳性，有微转移者12例（36.4%）17个淋巴结（8.0%）；而H－E 色仅发现7例（21.2%）14个淋巴结转移（7.5%），其中有微转移者仅2例（6.1%）2个淋巴结（1.1%）（P＜0.01），H－E阳性者CK全部阳性，H－E阴性的32例中用CK－IHS检出5例有淋巴结微转移。淋巴结微转移与卵巢癌患者的临床期别、细胞分化和生存时间有关。结论：CK染色可大大提高淋巴结微转移的检出率，对卵巢癌患者具有预后意义。

Detection of micrometastases in pelvic lymph nodes of patients with ovarian cancer and its clinical significance

Objectives: Detection of tumor micrometastases in resected pelvic lymph nodes of patients with epithelial ovarian cancer to obtain reliable information concerning nodal status for clinical and pathological importance. Methods:Tissue paraffin emboded blocks of 33 primary herds and 187 pelvic lymph nodes from 34 patients with epithelial ovarian cancer were examined by immunohistochemical staining using monoclonalantibody of anticytokeratins(CK18) and by HE staining respectivly. Results:Thirty three Tissue of primary herds were cytokeratin(CK) positive. Thirty one lymph nodes(16.6%)in 12 patients( 36.4 %) were CK positive,and 17 lymph nodes(9.1%) in 12 cases had micrometastases.But only 14 lymph nodes metastases(7.5%) was found in 7 cases(21.2%) by HE staining, among which there were 2 lymph nodes(1.1%)in 2 patients(6.3%) had micrometastases( P <0.01). The cases with HE positive were CK positive too,the micrometastases in 5 cases was detected by CK staining in 26 cases who were HE negative. The results also showed the lymph node micrometastase was correlated with clinical stage,cell differentiation and survival time in patients with ovarian cancer. Conclusions:The data suggested that the immunohistochemical technique can significantly facilitate the detection of micrometastatic tumor cells in lymph nodes.The frequency of pelvic lymphnode micrometastases may have signifcant impact on the prognosis of patients with ovarian cancer.