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目的应用RT-PCR技术检测pN0期非小细胞肺癌(NSCLC)患者淋巴结肺特异性X蛋白mRNA(Lunx mRNA)、基质金属蛋白酶-7mRNA(MMP-7mRNA)的表达情况,探讨其作为分子标记物对于微转移的诊断价值和临床意义。方法检测41例行根治术的pN0期非小细胞肺癌患者的171枚淋巴结中Lunx mRNA、MMP-7 mRNA的表达。结果15例(36.6%)患者的33枚(19.3%)淋巴结检测存在微转移,这部分患者的TNM分期被重新调整。伴有淋巴结微转移的患者较无微转移的患者有较短的5年生存期(P=0.000)。多因素分析显示,淋巴结微转移、临床分期为影响NSCLC预后的独立危险因素。结论早期诊断区域淋巴结中常规病理检查难以发现的微转移对于NSCLC患者的分子分期、临床治疗和预后判断有着重要的意义。
Objective To detect the expression of Lunx mRNA and MMP-7 mRNA in lymph nodes of pN0 non-small cell lung cancer (NSCLC) patients by RT-PCR. Diagnostic value and clinical significance of micrometastasis. Methods The expressions of Lunx mRNA and MMP-7 mRNA in 171 lymph nodes of 41 patients with pN0 non-small cell lung cancer undergoing radical operation were detected. Results Totally 33 (19.3%) lymph node micrometastases were detected in 15 (36.6%) patients and the TNM staging of these patients was readjusted. Patients with lymph node micrometastases had a shorter 5-year survival than patients without micrometastases (P = 0.000). Multivariate analysis showed that lymph node micrometastasis and clinical stage were independent risk factors affecting the prognosis of NSCLC. Conclusion The micrometastasis that is difficult to find by routine pathological examination in the early diagnosis of regional lymph nodes is of great significance for the molecular staging, clinical treatment and prognosis of patients with NSCLC.