应用RT-PCR检测CK19表达提高乳腺癌前哨淋巴结微转移检出的研究

目的:评价乳腺癌前哨淋巴结活检的临床意义,应用细胞角蛋白cytokeratin19(CK19)RT-PCR检测法提高其的敏感性及准确率.方法:随机选取1999年10月至2003年3月住院的乳腺癌患者73例,其中2001年1月至2003年3月的29例,对前哨淋巴结(SLN)进行了CK19 RT-PCR检测.采用专利兰进行SLN识别.RT-PCR法检测CK19 mRNA表达.结果:SLN识别成功67例,成功率为91.8%(67/73).对上述67例的SLN转移的常规病理诊断的敏感度68.8%(22/32),准确率85.1%(57/67).在行CK19 RT-PCR的29例中,检测出常规病理未检出的微小转移病例8例.敏感度90.0%(18/20),准确率93.1%(27/29).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CK19 RT-PCR检测SLN的微转移,可提高敏感度及准确率.

Detection of Micrometastasis in Sentinel Lymph Nodes of Breast Cancer Using CK19 RT-PCR

Objective: To evaluate the significance of sentinel lymph node biopsy (SLNB) in breast carcinoma and to improve the sensitivity and accuracy of SLNB by cytokeratin19(CK19)RT-PCR. Methods: Unselected 73 patients with breast carcinoma underwent SLNB using patent blue, and SLNs of 29 patients were detected with CK19 RT-PCR. Results: SLNs were identified in 67 patients (91.8%). The sensitivity and accuracy of routine examination of pathology for SLNs was 68.8%(22/32)and 85.1%(57/67) respectively. The sensitivity and accuracy of CK19 RT-PCR for SLNs was 90.0%(18/20)and 93.1%(27/29) respectively. Conclusions: SLNB is useful to determine the status of axillary lymph nodes of breast carcinoma. CK19 RT-PCR can improve the sensitivity and accuracy of SLNB.