Abstract
目的 应用荧光定量聚合酶链反应(PCR)及免疫组织化学方法对行根治性非小细胞肺癌手术患者的阴性淋巴结进行检测和分析,形成分子生物学分期.方法 共34例非小细胞肺癌患者根治术中193枚常规病理阴性淋巴结,进行CEAmRNA的荧光定量PCR及P53和角蛋白(AE1/AE3)免疫组织化学定性检测.根据检测结果重新确定患者的TNM分期,形成分子生物学分期,并进行平均40个月的随访.结果 肺癌阴性淋巴结CEAmRNA荧光定量PCR检测显示21.7%(42/193)阴性淋巴结阳性,共17例(17/34,50%)患者;8例患者常规病理分期上调;9例患者淋巴结阳性数目增加.肺癌阴性淋巴结P53免疫组织化学检测显示9.8%(19/193)阴性淋巴结阳性,共11例(11/34,32.4%)患者,2例患者常规病理分期上调;7例患者淋巴结阳性数目增加.肺癌阴性淋巴结AE1/AE3免疫组织化学检测显示18.6%(36/193)阴性淋巴结阳性,共15例患者(15/34,44.1%),4例患者常规病理分期上调;11例患者淋巴结阳性数目增加.三者之间差异有统计学意义(P＜0.05).结论 分子生物学技术及标记物可以更敏感的检出肺癌微转移,形成分子生物学分期.这种分期及微转移与非小细胞肺癌预后相关。
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