[可手术切除的非小细胞肺癌纵隔淋巴结微转移的检测]

[Detection of micrometastasis in mediastinal lymph nodes in operable non-small cell lung cancers].

作者信息

Yang Hao-xian, Wu Yi-long, Ding Jia-an, Jiang Ge-ning, Zhou Xiao, Chen Chang, Gao Wen, Chen Gang

机构信息

Department of Thoracic Surgery, Shanghai Pulmonary Disease Hospital, Tongji University, Shanghai, 200433, China.

出版信息

Zhonghua Zhong Liu Za Zhi. 2006 May;28(5):368-70.

PMID:17045003

Abstract

OBJECTIVE

Using the LUNX-mRNA as a marker and RT-PCR technique to assess mediastinal lymph nodes in patients with operable NSCLC, to evaluate at gene level the feasibility of this method in detection of micrometastasis in NSCLC and the necessity of systematic mediastinal lymphadenectomy during surgery.

METHODS

Twenty patients with operable NSCLC were involved in this study. The mediastinal lymph nodes were taken during operation. RT-PCR assay was carried out to detect the LUNX-mRNA. Ten cases with benign lung disease were assayed by the same method as control.

RESULTS

Seventy one mediastinal lymph nodes were obtained from 20 patients, 8 (11.3%) of which showed histologically metastasis with HE staining, while 23 (32.4%) were LUNX-mRNA positive by RT-PCR, P < 0.001. Micrometastasis was detected in 25.4% of all lymph nodes. LUNX-mRNA was found to be positive in 23.6% of lymph nodes from 15 patients with stage I A-II B NSCLC compared with 62.5% from 5 patients with stage III NSCLC, with a significant difference (P = 0.003).

CONCLUSION

About 25.4% of mediastinal lymph nodes are with micrometastasis in patients with operable NSCLC. Systematic mediastinal lymphadenectomy is necessary to deal with the regional lymph nodes during surgery.

摘要

目的

以肺癌特异标志物LUNX - mRNA为指标，应用逆转录聚合酶链反应（RT - PCR）技术检测可手术切除的非小细胞肺癌（NSCLC）患者纵隔淋巴结，从基因水平评估该方法检测NSCLC微转移的可行性及手术中系统性纵隔淋巴结清扫的必要性。

方法

选取20例可手术切除的NSCLC患者，术中获取纵隔淋巴结，采用RT - PCR法检测LUNX - mRNA，同时选取10例肺部良性疾病患者作为对照，采用相同方法检测。

结果

20例患者共获取71枚纵隔淋巴结，苏木精-伊红（HE）染色显示其中8枚（11.3%）有组织学转移，RT - PCR检测显示23枚（32.4%）LUNX - mRNA阳性，P < 0.001。所有淋巴结微转移检出率为25.4%。ⅠA - ⅡB期NSCLC患者15例的淋巴结中LUNX - mRNA阳性率为23.6%，Ⅲ期NSCLC患者5例的淋巴结中LUNX - mRNA阳性率为62.5%，差异有统计学意义（P = 0.003）。