Cytokeratin表达在舌鳞癌淋巴结微转移诊断中的应用

目的:研究一种检测舌鳞癌淋巴结微灶转移的方法.方法:对40例舌鳞癌患者及清扫淋巴结163个(常规临床检查颈部淋巴结阴性pN0)进行常规病理检查(HE染色)和细胞角蛋白(Cytokeratin,CK)抗体的免疫组化检测.结果:40例舌鳞癌组织中CK均表达阳性,40例颈淋巴结常规病理检查(HE染色)发现5例有转移者(共23枚淋巴结),CK检测也为阳性.19个淋巴结常规病理检查未发现转移者,CK也表达阳性.随着肿瘤T分期的增加,淋巴结CK表达阳性率亦增加.CK表达阳性者预后较阴性者差.结论:CK免疫组化法是检测舌鳞癌淋巴结微转移的敏感而便捷的方法,而检测舌鳞癌微转移有助于判断肿瘤进展程度与预后,特别对筛选组织学检查淋巴结阴性但存在微转移的患者有实用价值.

Significance of Cytokeratin Expression in Detecting Lymph Node Micrometastasis in Squamous Cell Carcinoma of the Tongue

Objective:To study a method of detecting lymph node micrometastasis in squamous cell carcinoma(SCC) of the tongue.Methods:General pathological examination(HE stain) and immunohistochemical examination with anti-cytokeratin(anti-CK) antibody were performed on 40 patients with SCC of the tongue and 163 lymph nodes from neck dissection.General clinical examination showed that these patients had a node-negative neck(pN0).Results:All 40 cases with tongue SCC were positive for CK.Of 40 cases,5 cases with metastasis(23 nodes in all) shown by general pathological examination(HE stain) were positive for CK;19 cases that were shown to have no metastasis by general pathological examination were also positive for CK.With the increase in T stage,the positive rate of lymph code CK increased as well.Patients positive for CK had a worse prognosis than those negative for CK.Conclusion:CK immunohistochemical method is a sensitive and convenient method of detecting lymph node micrometastasis in SCC of the tongue,and the detection of lymph node micrometastasis in SCC of the tongue helps estimate the development and prognosis of tumor.This method has a practical value for those patients that have a node-negative neck in screening histological examination have micrometastasis.