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目的明确新辅助治疗后以逆转录酶-聚合酶链反应(RT-PCR)法检测前列腺癌盆腔淋巴结微转移的意义。方法本组41例临床局限性前列腺癌病例,术前行淋巴管造影显示盆腔淋巴结,对可疑淋巴结在X线定位下穿刺抽吸淋巴液,用RT-PCR法检测淋巴液中前列腺特异性抗原(prostate-spe-cific antigen,PSA)mRNA和前列腺特异性膜抗原(prostate-specific membrane antigen,PSMA)mRNA的表达;术后对淋巴结组织切片进行免疫组化检查,将PSA mRNA或PSMA mRNA阳性作为存在微转移。结果对术前盆腔淋巴结穿刺抽吸淋巴液测PSA mRNA和PSMA mRNA,证实有21例淋巴结存在微转移,术后对清扫淋巴结予免疫组化检查有5例存在淋巴结转移,组织学检查阳性组与RT-PCR检测证实微转移组PSA mRNA和PSMA mRNA的表达存在明显差异。结论新辅助治疗后,采用RT-PCR法检测淋巴液中PSA mRNA和PSMA mRNA的表达有利于探测到淋巴结微转移。
Objective To determine the significance of neoadjuvant therapy in the detection of micrometastases in pelvic lymph nodes of prostate cancer by reverse transcriptase-polymerase chain reaction (RT-PCR). Methods The group of 41 cases of localized clinical prostate cancer, preoperative lymphangiography showed pelvic lymph nodes, the suspicious lymph nodes in the X-ray positioning aspirated lymph suction, RT-PCR detection of lymphoid prostate specific antigen ( (PSA-PSA) mRNA and prostate-specific membrane antigen (PSMA) mRNA. Immunohistochemistry was performed on the sections of lymph nodes and PSA mRNA or PSMA mRNA was positive Micro-transfer. Results Preoperative pelvic lymph node aspiration and aspiration of lymph fluid were used to measure PSA mRNA and PSMA mRNA. Twenty-one lymph nodes were confirmed to have micrometastasis. Lymph node metastasis was detected in 5 cases of lymph node dissection and positive histological examination with RT-PCR showed that the expression of PSA mRNA and PSMA mRNA in micrometastasis group were significantly different. Conclusion After neoadjuvant therapy, the expression of PSA mRNA and PSMA mRNA in lymph was detected by RT-PCR, which is helpful to detect micrometastasis in lymph nodes.