【摘要】 目的探讨早期宫颈癌患者淋巴结中细胞角蛋白19(CK-19)mRNA和人乳头状瘤病毒(HPV)DNA(16/18型)的表达及联合检测的临床意义。方法采用逆转录-聚合酶链反应(RT-PCR)技术、荧光定量-聚合酶链反应(FQ-PCR)技术,检测CK-19mRNA和HPVDNA(16/18型)在30例早期宫颈癌患者194枚淋巴结中的阳性率及二者联合检测的敏感度和准确度。结果 30例早期宫颈癌患者的淋巴结194枚,常规病理学HE染色检出8例患者26枚淋巴结转移、22例患者无转移淋巴结164枚。在22例HE染色未检出淋巴结转移组中,聚合酶链反应检测9例患者40枚淋巴结CK-19mRNA呈阳性,12例患者68枚淋巴结HPVDNA(16/18型)呈阳性。转移淋巴结组和无转移淋巴结组CK-19mRNA阳性率分别为92.3和23.8,HPVDNA(16/18型)阳性率分别为96.2和40.5;比较两组淋巴结CK-19mRNA和HPVDNA(16/18型)阳性检出率,转移淋巴结组明显高于无转移淋巴结组(P<0.01)。单独检测CK-19mRNA敏感度为33.0,HPVDNA敏感度为47.9;采用二者联合检测,敏感度可达76.8,准确度为81.8。结论 CK-19mRNA和HPVDNA(16/18型)可作为判断早期宫颈癌淋巴结微转移的参考指标,二者联合检测有较高的检出率。更多还原

【Abstract】 Objective To study the expression of cytokeratin 19(CK-19) mRNA and human papilloma virus(HPV) DNA(16/18 type) in lymph nodes of patients with early stage uterine cervix cancer(UCC),and to explore the clinical significance of combined detection.Methods Reverse transcription-polymerase chain reaction(RT-PCR) technology,quantitative-polymerase chain reaction(FQ-PCR) technique had been used to detect CK-19 mRNA and HPV DNA(16/18 type) in 194 lymph nodes from 30 patients with early stage UCC,including positive rate and sensitivity and accuracy of combination detection.Results In 194 lymph nodes,there were 26 lymph nodes from 8 patients with metastasis,and 164 lymph nodes from 22 patients without metastatic detected by routine HE staining.In non metastatic group,there were 40 lymph nodes from 9 patients positive for CK-19 mRNA,and 68 lymph nodes from 12 patients positive for HPV DNA(16/18 type),which were detected by RT-PCR.The positive rates of CK-19 mRNA of metastatic group and non metastatic group were 92.3% and 23.8%,respectively,and the positive rates of HPV DNA(16/18 type) were 96.2% and 40.5%,respectively.Compared with non metastatic group,the positive rates of CK-19 mRNA and HPV DNA(16/18 type) were significantly higher(P<0.01).The sensitivity of CK-19 mRNA individual detection was 33.0%,and 47.9% was for HPV DNA(16/18 type).The sensitivity and accuracy were up to 76.8% and 81.8% respectively in combined detection.Conclusion CK-19 mRNA and HPV DNA(16/18 type) could be used as UCC lymph node micrometastasis in early reference.The combined detection had a higher detection rate.更多还原