【摘要】 背景与目的:常规病理检查漏诊的纵隔淋巴结隐匿性微小转移可能与肺癌的预后有关。本研究旨在探索肺癌纵隔淋巴结隐匿性微转移的诊断,并评价其对预后意义。方法:应用逆转录聚合酶链反应法（RT-PCR）,对58例非小细胞肺癌手术后病理检查阴性的242组纵隔淋巴结（pN₀）进行研究,检测淋巴结中MUC1基因mRNA表达,诊断纵隔淋巴结隐匿性微转移。对全部病人随访3年,应用Kaplan-Meier法计算生存率,log-rank检验比较有、无淋巴结隐匿性微转移患者的生存差别。结果:16例患者的23组纵隔淋巴结中检测到MUC1基因mRNA表达,诊断为纵隔淋巴结隐匿性微转移,占全部患者的27.6％。患者的TNM分期由Ⅰ_A～Ⅱ_B期上调为Ⅲ_A期。纵隔淋巴结隐匿性微转移组3年生存率为43.7％（7/16）,无转移组的3年生存率为73.8％（31/42）。两组的生存差别具有显著性（P<0.05）。结论:纵隔淋巴结中MUC1基因mRNA的表达与pN₀患者预后不良有关。提示肺癌患者纵隔淋巴结MUC1基因mRNA阳性表达,可以作为判断可能存在淋巴结隐性微转移的参考指标。更多还原

【Abstract】 BACKGROUND & OBJECTIVE: occult micrometastasis tomediastina! lymph node, which could not be detected by routinely histopathologic examination, might be correlated with the prognosis of patients with non-small cell lung carcinoma (NSCLC). The aim of this stud y was to diagnose occult micrometastasis of mediastinal lymph node in NSCLC patients and evaluate its prognostic significance. METHODS: Using reverse transcription-polymerase chain reaction (RT-PCR), 242 stations of mediastinal lymph nodes, which were free of tumor determined by histopathologic examination(pNO), from 58 patients were examined for MUC1 gene mRNA and to diagnose occult micrometastasis. All the patients were followed-up for three years. The survival rate was calculated by Kaplan-Meier method and the survival was compared with log-rank test between the patients with and without occult nodal micrometastasis. RESULTS: The MUC1 gene mRNA was identified in 23 stations of lymph nodes from 16 patients, and nodal occult micrometastasis was diagnosed in the 27.6% of the patients. TNM staging for these patients was up-regulated from stage ⅠA - ⅡB to stage Ⅲ A. The 3-year survival rate in the patients with nodal occult micrometastasis (43. 7% ) was lower than that in the patients without nodal occult micrometastasis (73. 8% ) ( P < 0.05). CONCLUSION: The expression of MUC1 gene mRNA in mediastinal lymph node is associated with poor prognosis of NSCLC patients with pNO disease, suggesting that it may be an indicator of poor prognosis.更多还原