结直肠癌前哨淋巴结微转移免疫组化检测的临床意义

目的探讨Cytokeratin-18(CK-18)免疫组织化学在结直肠癌前哨淋巴结转移检测中的应用价值。方法自2003年5月至2004年3月采用CK-18免疫组织化学方法检测99例SLN组织微转移癌。结果常规病理检测发现结直肠癌淋巴结转移45例,未转移54例。99例SLN常规病理癌转移阴性81例,其中CK-18免疫组织化学检测发现微转移31例。CK-18染色将15%(8/54)常规病理Dukes’A及B期患者肿瘤分期提升为Dukes’C期。CK-18免疫组织化学判定结直肠癌淋巴结转移的敏感性为98%,特异性为96%,准确度为97%。结论CK-18免疫组织化学检测结直肠癌SLN有助于提高Dukes’A及B期结直肠癌的病理分期。

Significance of detected micro-metastasis with immunohistochemistry in sentinal lymph node of colorectal carcinoma

Objectives To investigate the value of immunohistochemistry to detect the micro-metastasis in sentinal lymph node(SLN) of colorectal carcinoma(CRC). Methods From may 2003 to March,CK-18 immunohistochemistry was used in 99 cases with SLN micro-metastasis of CRC. Results 45 cases with lymph node metastasis was found by routine pathologic examnation. 81 cases were negative for SLN metastasis,while CK-18 immunohistochemical staining showed micrometastasis in 31 cases. 15%(8/54) tumor staging were elevated from Duke's A and B to Duk's C by CK-18 staining. In judging lymph metastasis of CRC,CK-18 immunohistochemistry's sensitivity,specificity and accuracy were 98%,96% and 97%,respectively. Conclusions SLN CK-18 immunohistochemical staining is helpful for raising tumor stages from Dukes' A and B to Dukes'C in CRC.