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目的 应用逆转录聚合酶链反应 (RT PCR)方法检测胃癌淋巴结微转移 ,探讨淋巴结微转移与胃癌生物学行为的关系。方法 对中山大学附属第一医院 2 0 0 3年 12月至 2 0 0 4年 4月间行手术切除的 30例胃癌共85 0枚淋巴结采用CK 2 0mRNART PCR扩增检测微转移 ,分析微转移的临床病理特点。结果 14例 (46 7% )77枚 (12 5 % )淋巴结检出淋巴结微转移。弥漫型胃癌的微转移阳性率为 6 3 2 % (12 / 19) ,明显高于肠型胃癌的18 2 % (2 / 11,P <0 0 5 )。肿瘤浸润深度越深 ,微转移的检出率越高。结论 CK 2 0mRNART PCR法可以检测出常规病理学检查遗漏的淋巴结微转移 ,可显著提高淋巴结转移的检出率。淋巴结微转移与Lauren分型和浸润深度密切相关。
Objective To detect the lymph node micrometastases in gastric cancer by reverse transcription polymerase chain reaction (RT-PCR) and to explore the relationship between the micrometastasis in lymph nodes and the biological behavior of gastric cancer. Methods Totally 85 0 lymph nodes of 30 cases of gastric cancer who underwent surgical resection from December 2003 to April 2004 at First Affiliated Hospital of Sun Yat-sen University were examined for micrometastases by CK 2 0mRN PCR amplification and micrometastasis The clinical and pathological features. Results Lymph node micrometastasis was detected in 77 (125%) lymph nodes in 14 cases (46.7%). The positive rate of micrometastasis in diffuse gastric cancer was 62.2% (12/19), which was significantly higher than that of intestinal type gastric cancer (18.2%, 2/11, P <0 05). The deeper the depth of tumor invasion, the higher the detection rate of micrometastasis. Conclusion The CK20mRNA PCR method can detect micrometastases of lymph nodes missed by routine pathological examination and can significantly improve the detection rate of lymph node metastasis. Lymph node micrometastasis and Lauren classification and depth of invasion are closely related.