【摘要】：目的選擇CK20作為目標(biāo)檢測(cè)物,使用IHC和RT-PCR法共同檢測(cè)常規(guī)病理方法診斷為pNO期的胃腺癌患者淋巴結(jié),統(tǒng)計(jì)分析胃腺癌淋巴結(jié)微轉(zhuǎn)移與術(shù)前可獲得的臨床病理因素的關(guān)系,探索同時(shí)使用免疫組化法和RT-PCR法進(jìn)行胃腺癌淋巴結(jié)微轉(zhuǎn)移檢測(cè),探討胃腺癌淋巴結(jié)微轉(zhuǎn)移的臨床意義。方法選取2013年1月到2016年6月期間于寧夏回族自治區(qū)人民醫(yī)院接受手術(shù)的pNO期胃癌患者32例,收集術(shù)后淋巴結(jié)組織蠟塊共158個(gè),所有淋巴結(jié)均經(jīng)切片HE染色檢查,病理診斷為NO。應(yīng)用免疫組織化學(xué)染色法和RT-PCR法聯(lián)合檢查其中CK20的表達(dá),進(jìn)行統(tǒng)計(jì),分析胃腺癌淋巴結(jié)微轉(zhuǎn)移與患者性別、年齡、腫瘤部位、腫瘤大小、浸潤(rùn)深度及分化程度等術(shù)前可獲得的臨床病理資料的關(guān)系。結(jié)果經(jīng)免疫組織化學(xué)染色法檢測(cè)出7例患者,共14個(gè)淋巴結(jié)CK20陽(yáng)性,陽(yáng)性率為21.87%;經(jīng)RT-PCR法檢測(cè)出10例患者,共23個(gè)淋巴結(jié)中CK20mRNA陽(yáng)性,陽(yáng)性率為31.25%。兩種方法檢測(cè)結(jié)果均為陽(yáng)性的患者有6例,RT-PCR法結(jié)果呈陽(yáng)性而免疫組化法結(jié)果呈陰性的患者有4例,免疫組化法結(jié)果陽(yáng)性而RT-PCR法結(jié)果陰性患者1例。兩種檢測(cè)方法共檢出11例患者存在微轉(zhuǎn)移。不同分化程度的胃腺癌淋巴結(jié)微轉(zhuǎn)移之間差異有統(tǒng)計(jì)學(xué)意義(P0.05)。淋巴結(jié)微轉(zhuǎn)移與胃腺癌的分化程度有關(guān),低分化胃腺癌較中-高分化胃腺癌容易出現(xiàn)微轉(zhuǎn)移,淋巴結(jié)微轉(zhuǎn)移與胃腺癌患者的年齡、性別、腫瘤部位,腫瘤大小及浸潤(rùn)深度無(wú)關(guān)。結(jié)論胃腺癌淋巴結(jié)微轉(zhuǎn)移與分化程度有關(guān),低分化胃腺癌較中-高分化胃腺癌容易出現(xiàn)微轉(zhuǎn)移。免疫組化法和RT-PCR法聯(lián)合檢測(cè)胃腺癌淋巴結(jié)微轉(zhuǎn)移有提高微轉(zhuǎn)移檢出率的趨勢(shì)。
[Abstract]:Objective to select CK20 as the target detection material and to detect lymph nodes in patients with gastric adenocarcinoma diagnosed as pNO by IHC and RT-PCR, and to analyze the relationship between lymph node micrometastasis of gastric adenocarcinoma and clinicopathological factors available before operation. To explore the clinical significance of the detection of lymph node micrometastasis in gastric adenocarcinoma by immunohistochemical method and RT-PCR method. Methods from January 2013 to June 2016, 32 patients with pNO stage gastric cancer underwent operation in Ningxia Hui Autonomous region people's Hospital. A total of 158 lymph nodes were collected. All lymph nodes were examined by HE staining. Pathological diagnosis of NO. Immunohistochemical staining method and RT-PCR method were used to detect the expression of CK20 and to analyze the relationship between lymph node micrometastasis and sex, age, tumor location, tumor size. The relationship between the depth of invasion and the degree of differentiation. Results the positive rate of CK20 was 21.87 in 14 lymph nodes of 7 cases detected by immunohistochemical staining and 31.25% in 23 lymph nodes of 10 cases detected by RT-PCR method. There were 6 cases with positive results by both methods, 4 cases with positive results by RT-PCR and negative results with immunohistochemistry, and 1 case with positive results by immunohistochemical method and negative results with RT-PCR method. Micrometastasis was detected in 11 patients by two methods. The difference of lymph node micrometastasis of gastric adenocarcinoma with different differentiation degree was statistically significant (P0.05). Lymph node micrometastasis was related to the differentiation degree of gastric adenocarcinoma. The micrometastasis was more likely to occur in poorly differentiated gastric adenocarcinoma than that in moderately well differentiated gastric adenocarcinoma. There was no correlation between lymph node micrometastasis and age, sex, tumor location, tumor size and depth of invasion in patients with gastric adenocarcinoma. Conclusion lymph node micrometastasis is related to the degree of differentiation in gastric adenocarcinoma, and micrometastasis is more likely in poorly differentiated gastric adenocarcinoma than in moderately well differentiated gastric adenocarcinoma. The detection of lymph node micrometastasis in gastric adenocarcinoma by immunohistochemical method and RT-PCR method has a tendency to increase the detection rate of micrometastasis.
【學(xué)位授予單位】：寧夏醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R735.2

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