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目的分析淋巴结微转移对胃癌pN分期的影响。方法采用CK-20mRNA逆转录聚合酶链反应(RT-PCR)技术对2003年12月至2004年4月间行手术切除的30例胃癌患者共计850枚淋巴结扩增检测微转移。结果应用苏木精-伊红染色法淋巴结转移检出率为27.1%(233/850),而RT-PCR法淋巴结转移的检出率则为36.5%(310/850);两种方法比较,P<0.01,差异有统计学意义。77枚淋巴结检出有微转移(12.5%,77/617)。有7例(23.3%)患者的肿瘤TNM分期提高,分别为ⅠB→Ⅱ、ⅠB→ⅢA、Ⅱ→ⅢA、ⅢA→ⅢB、ⅢA→Ⅳ各1例,ⅢB→Ⅳ2例。结论RT-PCR法可以显著提高淋巴结转移的检出率,有助于更准确地进行临床病理分期。
Objective To analyze the effect of lymph node micrometastasis on pN staging of gastric cancer. Methods CK-20 mRNA reverse transcriptase polymerase chain reaction (RT-PCR) was used to detect micrometastases in a total of 850 lymph node metastases from 30 patients with gastric cancer who underwent surgical resection between December 2003 and April 2004. Results The detection rate of lymph node metastasis by hematoxylin-eosin staining was 27.1% (233/850), and the detection rate of lymph node metastasis by RT-PCR was 36.5% (310/850). Comparing the two methods, P<0.01, the difference was statistically significant. Micrometastasis was detected in 77 lymph nodes (12.5%, 77/617). Tumor TNM staging increased in 7 patients (23.3%), including IB→II, IB→IIIA, II→IIIA, IIIA→IIIB, IIIA→IV, and IIIB→IV2. Conclusion RT-PCR method can significantly increase the detection rate of lymph node metastasis and help to more accurately perform clinical pathological staging.