【摘要】 目的:探讨乳腺癌腋窝levelⅢ组淋巴结微转移的检测方法。评价腋窝levelⅢ组淋巴结微转移与乳腺癌患者临床病理特征的关系。方法:2005年6月至2007年8月,收集75例腋窝levelⅢ组淋巴结阴性患者的腋窝levelⅢ组淋巴结,使用连续多层切片HE染色和连续多层切片EMA、CK19免疫组织化学染色检测腋窝levelⅢ组淋巴结微转移状态,分析腋窝levelⅢ组淋巴结微转移与乳腺癌患者临床病理特征的关系。结果:在75例患者中共检出235枚腋窝levelⅢ组淋巴结,使用连续多层切片HE染色法发现6例6枚淋巴结存在微转移灶,另有3例3枚淋巴结的单个或多个癌细胞EMA和CK19均表达阳性。联合检测法的腋窝levelⅢ组淋巴结微转移检出率为3.83%(9/235),腋窝levelⅢ组淋巴结阴性患者微转移的阳性率为12.00%(9/75),腋窝levelⅢ组淋巴结微转移与患者的肿瘤大小、组织学分级、腋窝level Ⅰ组淋巴结转移状态、腋窝levelⅡ组淋巴结转移状态和病理分期密切相关。结论:使用连续多层切片HE染色法,连续多层切片EMA、CK19免疫组织化学染色检测法检测腋窝levelⅢ组淋巴结微转移是可行的,肿瘤大小、组织学分级、腋窝level Ⅰ、levelⅡ组淋巴结转移状态和病理分期可以作为预测乳腺癌腋窝levelⅢ组淋巴结微转移临床病理指标。更多还原

【Abstract】 Objective:To investigate the feasibility of the detection of micrometastases in axillary level Ⅲ lymph nodes and to explore the relationship between micrometastases of axillary level IE lymph nodes and clinicopathologic parameters in patients with breast cancer. Methods:Axillary level HI negative lymph nodes confirmed by routine H&E staining in 75 female patients with breast cancer between June 2005 and August 2007. The micrometastases in axillary level Ⅲ lymph nodes were tested by H&E staining and immunohistochemistry. The correlations between micrometastases of axillary level Ⅲ lymph nodes and clinicopathologic parameters were assayed. Results:A total of 235 axillary level Ⅲ lymph nodes were collected. Micrometastases were found by series H&E staining in 6 axillary level Ⅲ lymph nodes from 6 patients. Three axillary level Ⅲ lymph nodes from 3 patients were found with micrometastases through detecting CK19 and EMA with immunohistochemical staining. The positive rate of micrometastases in axillary level Ⅲ lymph nodes was 12.00% (9/75) in patient with breast cancer of axillary level Ⅲ negative lymph nodes. There were significant correlations between micrometastases of axillary level Ⅲ lymph node and tumor sizes, histological grade, axillary level Ⅰ lymph node involvement, axillary level Ⅱ lymph node involvement and pathological stages. Conclusion: Micrometastases of axillary level Ⅲ lymph nodes can be detected by H&E staining and CK19 and EMA immunohistochemical staining. Tumor sizes, histological grade, axillary level I lymph node involvement, axillary level Ⅱ lymph node involvement and pathologic stages may be useful indices for predicting micrometastases in axillary level Ⅲ lymph nodes in patients with breast cancer.更多还原