免疫组化检测广谱细胞角蛋白诊断胰腺癌淋巴结微转移灶的价值

目的以抗广谱细胞角蛋白(pan-cytokeratin,CK)单克隆抗体为第一抗体,采用免疫组化技术检测胰腺癌淋巴结微转移。方法采用连续切片方法,对54例胰腺癌患者的938个淋巴结进行CK和HE的双重染色。结果54例病人中,CK染色发现10例病人共42个淋巴结出现微转移,其中有8例为常规病理诊断无淋巴结微转移的病例,漏诊率为15.3%,CK染色微转移灶检出率为4.4%(42/938),而常规HE染色阳性率仅为1.0%(10/938),两者差别有显著性意义(P<0.001)。结论常规的H-E切片检测很难发现淋巴结的微转移病灶,我们采用CK标记淋巴结的方法弥补了常规HE观察的不足,提高了胰腺癌的淋巴结转移检出率,对患者的预后判断和指导临床治疗具有重要的指导意义。

Diagnosis of micrometastasis in lymph nodes of patients with pancreatic cacarcinoma by using pan CK staining

Purpose To detect micrometastasis of pancreatic carcinoma by labeling cytokeratin with immuneohistochemistry in lymph nodes around the dissected pancreatic carcinoma specimen.Methods Equential slices methods was used to examine 938 lymph nodes by cytokeratin(CK) staining and routine hematoxylin-eosin(HE) staining.Results The positive rates of lymph nodes metastasis detected with routine histology and CK staining were 1.0%(10/938) and 4.4%(42/938),respectively.There was significant difference(P<0.001) in the diagnosis of lymph nodes metastasis between CK and HE staining.The diagnosis ratio of micrometastasis raised about 15.3%(8/52) by CK staining than HE staining.Conclusions Cytokeratin staining is necessary in accurate evaluation of lymph node metastasis of pancreatic carcinoma,and has important clinical significance in evaluating prognosis and directing treatment.