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[目的]通过检测早期宫颈癌前哨淋巴结(SLN)中CK19 mRNA(cytokeratin 19)的表达,探讨CK19mRNA对宫颈癌淋巴结微转移检测的临床意义。[方法]①选择2007年12月～2008月12月昆明医学院第三附属医院(云南省肿瘤医院)妇科肿瘤临床研究中心早期宫颈癌初治患者30例。所有患者均行子宫广泛切除术和双盆腔淋巴结清扫术。②采用放射性核素联合亚甲蓝的方法识别SLN,逆转录-多聚酶链式反应(RT-PCR)方法检测SLN中CK19 mRNA的表达,与常规病理组织学方法比较,分析CK19 mRNA对早期宫颈癌淋巴结微转移检测的临床意义。[结果]①30例宫颈癌患者共检出SLN标本55枚,其中常规病理组织学方法检测SLN阳性率为14.5%(8/55)。经RT-PCR法检测SLNCK19mRNA阳性率为32.7%(18/55)。经常规病理组织学方法证实无癌转移的47枚淋巴结中,10枚CK19 mRNA表达阳性,阳性率为21.3%(10/47)。二者之间比较差异有统计学意义。②CK19 mRNA表达与病理类型有相关性(P﹤0.05)。[结论]与传统的病理组织学比较,采用RT-PCR技术检测淋巴结中CK19 mRNA表达能显著提高微转移的检出率。
[Objective] To investigate the clinical significance of CK19 mRNA in the detection of lymph node micrometastasis in cervical cancer by detecting the expression of CK19 mRNA (cytokeratin 19) in sentinel lymph node (SLN) of early cervical cancer. [Methods] ①30 patients with newly diagnosed cervical cancer in the Gynecologic Oncology Clinical Research Center of the Third Affiliated Hospital of Kunming Medical College (Yunnan Cancer Hospital) from December 2007 to December 2008 were selected. All patients underwent hysterectomy and double pelvic lymph node dissection. ② The expression of CK19 mRNA in SLN was detected by reverse transcription-polymerase chain reaction (RT-PCR) method using radionuclide combined with methylene blue to identify SLN. Compared with routine histopathological methods, the expression of CK19 mRNA in early cervical cancer Clinical significance of lymph node micrometastasis detection. [Results] 55 SLN specimens were detected in 30 patients with cervical cancer. The positive rate of SLN detected by routine histopathology was 14.5% (8/55). The positive rate of SLNCK19 mRNA by RT-PCR was 32.7% (18/55). Of the 47 lymph nodes confirmed by pathological histology, 10 CK19 mRNAs were positive, with a positive rate of 21.3% (10/47). The difference between the two was statistically significant. ② The expression of CK19 mRNA was correlated with pathological type (P <0.05). [Conclusion] Compared with the traditional histopathology, the detection of CK19 mRNA expression in lymph nodes by RT-PCR can significantly improve the detection rate of micrometastasis.