CK19表达及其在喉鳞癌淋巴结微转移诊断中的应用

目的:研究用免疫组化方法检测CK19及其在喉鳞癌淋巴结微转移诊断中应用与临床病理意义。方法:对40例喉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)和抗角蛋白19抗体的免疫组化检测。结果:40例喉鳞癌组织中CK19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),CK19检测也为阳性。19个淋巴结常规病理检查未发现转移者,CK19也表达阳性。随着肿瘤T分期的增加,淋巴结CK19表达阳性率亦增加。CK19表达阳性者预后较阴性者差。结论:CK19免疫组化法是检测喉鳞癌淋巴结微转移的敏感而便捷的方法,而检测喉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病人有实用价值。

Significance of CK19 expression in detecting lymph node micrometastases in patients with laryngeal carcinoma

AIM: To evaluate the significance of cytokeratin19 (CK19) expression in diagnosing micrometastases in lymph nodes in patients with laryngeal carcinoma. METHODS: Forty cases of laryngeal carcinoma together with 163 lymph nodes were studied by the staining with hematoxylin and eosin(HE)and immunostaining with antibody against cytokeratin 19 (CK19) on histological sections of the primary tumor and regional lymph nodes. RESULTS: In all cases, CK19 was positively expressed in the primary tumor. Among 163 lymph nodes, metastases were confirmed by HE in 23 lymph nodes, and in 42 lymph nodes staining with immunohistochemistry, micrometastases were found in 19 lymph nodes. Micrometastases in the lymphonodes were significantly related to the T staging. CONCLUSION: Immunohistochemical staining is a valuable method for the detection of node micrometastases in patients with laryngeal carcinoma.