Shores Carol G, Yin Xiaoying, Funkhouser William, Yarbrough Wendell
Department of Otolaryngology/Head and Neck Surgery, Neurosciences Hospital, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
Arch Otolaryngol Head Neck Surg. 2004 Aug;130(8):937-42. doi: 10.1001/archotol.130.8.937.
To better detect occult cervical metastases.
RNA from 153 cervical lymph nodes was analyzed for the presence of squamous cell carcinoma using quantitative cytokeratin (CK) 14 real-time reverse transcription polymerase chain reaction (RT-PCR). Detection of CK RNA in pathologically negative nodes was further analyzed by semi-step sectioning and CK immunohistochemistry. Subjects Thirteen consecutive patients with head and neck squamons cell carcinoma (HNSCC) presenting to the Department of Otolaryngology/Head and Neck Surgery of the University of North Carolina at Chapel Hill for neck dissection.
Cytokeratin detection was deemed nonspecific if expressed at fewer than 50 molecules of CK 14 RNA per nanogram total RNA. Of 35 HNSCCs, 33 expressed CK 14 RNA, and 15 lymph nodes with routine pathologically positive metastasis were also positive for CK 14 RNA. Four lymph nodes that were pathologically negative nodes were positive for CK 14 RT-PCR, with 2 containing metastases detected by semi-step sectioning.
Cytokeratin 14 RT-PCR is very sensitive for detecting micrometastasis in lymph nodes that are negative by routine pathological examination, with a relatively high false-positive rate. Quantitative CK 14 RT-PCR could be used to identify nodes negative for tumor by standard pathological analysis that should be examined by step sectioning and CK immunohistochemistry. Identification of micrometastases in patients with HNSCC will allow for appropriate and aggressive treatment of patients with metastatic disease.
更好地检测隐匿性颈部转移。
使用定量细胞角蛋白（CK）14实时逆转录聚合酶链反应（RT-PCR）分析153个颈部淋巴结的RNA，以检测鳞状细胞癌的存在。通过半连续切片和CK免疫组织化学进一步分析病理检查阴性淋巴结中CK RNA的检测情况。研究对象连续13例头颈部鳞状细胞癌（HNSCC）患者，就诊于北卡罗来纳大学教堂山分校耳鼻咽喉头颈外科进行颈部清扫术。
如果每纳克总RNA中CK 14 RNA的表达量少于50个分子，则认为细胞角蛋白检测是非特异性的。在35例HNSCC中，33例表达CK 14 RNA，15个常规病理检查有阳性转移的淋巴结CK 14 RNA也呈阳性。4个病理检查阴性的淋巴结CK 14 RT-PCR呈阳性，其中2个通过半连续切片检测到有转移。
细胞角蛋白14 RT-PCR对检测常规病理检查阴性的淋巴结中的微转移非常敏感，但假阳性率相对较高。定量CK 14 RT-PCR可用于识别标准病理分析为肿瘤阴性的淋巴结，这些淋巴结应通过连续切片和CK免疫组织化学进行检查。识别HNSCC患者中的微转移将有助于对转移性疾病患者进行适当且积极的治疗。
