结直肠癌淋巴结中黏蛋白1的表达和临床意义

目的研究结直肠癌区域淋巴结中黏蛋白1（MUC1）的表达，以寻找1种检测结直肠癌淋巴结微转移的可靠指标。方法采用免疫组织化学Elivision法，对69例结直肠癌457枚区域淋巴结中MUC1的表达进行检测和分析。结果常规病理学检查无转移的结直肠癌淋巴结，其MUC1的阳性表达率（淋巴结微转移率）为18．6％（61／328），DukesA、B和C期淋巴结微转移率分别是4．7％（3／64）、16．8％（28／167）和30．9％（30／97）。DukesA、B和C期转移淋巴结的检出率分别是4．7％（3／64）、16．8％（28／167）和70．4％（159／226）。免疫组织化学方法对结直肠癌转移淋巴结的检出率显著高于常规病理检查（P〈0．05），淋巴结微转移率和转移淋巴结的检出率随Dukes期别上升呈显著递增（P〈0．05）。1例DukesA期患者，9例B期患者因免疫组织化学检测到微转移，分期从DukesA或B期上调至C期。结论MUC1在结直肠癌区域淋巴结中有表达，是检测淋巴结微转移可靠指标。检测淋巴结中MUC1的表达可更准确的对结直肠癌进行临床分期。

The Expression and Clinical Significance of MUC1 in Regional Lymph Nodes of Colorectal Cancer

Objective To determine the expression of MUC1 in regional lymph nodes from colorectal cancer to look for a reliable indicator in the detection of lymph node micrometastasis.Methods MUC1 was detected in 457 lymph nodes from 69 patients with colorectal cancer by immunohistochemistry.Results The expression rate of MUC1 was 18.6%(61/328) in histologically negative lymph nodes(lymph node micrometastasis rate),of which in Dukes A,B and C,the lymph node micrometastasis rate was 4.7%(3/64),16.8%(28/167) and 30.9%(30/97) distinctively.The detection rate of metastatic lymph nodes in Dukes A,B and C was(4.7%)(3/64),16.8%(28/167) and 70.4%(159/226) distinctively by immunohistochemistry.The detection rate of metastatic lymph nodes was significantly higher by immunohistochemistry than that by routine histological examination(P<0.05),and the detection rate of metastatic lymph nodes and lymph node micrometastasis rate increased significantly with Dukes stage upstaged(P<(0.05)).Being detected micrometastasis immunohistochemically,one patient in Dukes A and 9 patients in Dukes B were upstaged to stage C.Conclusion The expression of MUC1 was found positively in regional lymph nodes from colorectal cancer,and it's a reliable indicator for detection of lymph node micrometastasis.It can provide more accurate staging for colorectal cancer by detection the MUC1 in lymph node.