乳腺癌前哨淋巴结CK19 mRNA和蛋白的表达

目的 探讨CK19微转移分子在乳腺癌前哨淋巴结(SLN)的表达情况及意义.方法 采用免疫组化S-P法及原位杂交技术检测66例SLN中CK19微转移分子的表达.同时与常规病检法比较其检测敏感性.并比较转移组、微转移组、无转移组患者的临床资料.结果 66例SLN在常规病理检查阴性38例淋巴结中6例表达CK19蛋白15.8%(6/38),8例21.1%(8/38)表达CK19mRNA.原位杂交法与常规病检法转移的检出率相比较,差异有统计学意义(P＜0.05).CK19蛋白和mRNA表达之间差异无统计学意义(P＞0.05).同时乳腺癌转移组与微转移组患者在肿物大小与淋巴管浸润上有相似性,而同无转移组差异有统计学意义(P＜0.05).结论 免疫组化法和原位杂交法较常规病理检查更为敏感.通过免疫组化法和原位杂交法的联合使用,可明显提高乳腺癌SLN微转移的检出率,同时也证明原位杂交法是可靠的,比免疫组化更为敏感的技术.SLN微转移有可能作为肿瘤预后的指标.

Expression of CK19 mRNA and protein in SLN of breast cancers

Objective To investigate the significance of CK19 micrometastasis expression in sentinel lymph node(SLN) of breast cancer. Methods Paraffin embedded tissues from 66 SLNs were analyzed for CK19 micrometastasis expression by immunohistochemistry(IHC)and in situ hybridization (ISH ) techniques.The sensitivity of the method of IHC was compar with that routin pathologic examination.At the same time,various clinic pathologic parameters were contrasted among metastasis negative group,micro-metastasis group and nonmetastasis group. Results 38 metastasis negative patients detected by the routine pathology, 6 of which CK19 protein expression was positive by IHC method. 8 of 38 metastasis negative patients detected by the routine pathology, in which CK19 mRNA positive detected by ISH method, The detection of metastasis rate of SLN had significant difference between ISH and the routine pathologic examination (P<0.05). Between expression of CK19 protein and CK19 mRNA had no statiscal difference (P>0.05). The micro-metastasis group was similar with the metastasis group in tumor size and lymphatic vessel invasion,which was significantly (P<0.05) different with that of metastasis-negative group. Conclusion The IHC and ISH is more sensitive than the routine pathological method for the detection of micrometastasis.The combinated utilization of ICH and ISH can greatly improve the detective efficiency of micro-metastasis in SLNs. The ISH is more sensitive than the ICH method for the detection of micrometastasis. Micrometastasis in SLN maybe used as a prognostic indicator.