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[1]陳新富 劉 寧 劉加夫.CK19在非小細(xì)胞肺癌淋巴結(jié)微轉(zhuǎn)移中的檢測(cè)價(jià)值(附90例分析)[J].福建醫(yī)藥雜志,2020,42(04):6-9.
　CHEN Xinfu,LIU Ning,LIU Jiafu..Detection value of CK19 in lymph node micrometastasis of NSCLC:analysis of 90 cases[J].FUJIAN MEDICAL JOURNAL,2020,42(04):6-9.
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CK19在非小細(xì)胞肺癌淋巴結(jié)微轉(zhuǎn)移中的檢測(cè)價(jià)值(附90例分析)()
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《福建醫(yī)藥雜志》[ISSN:1002-2600/CN:35-1071/R]

卷:
42
期數(shù):
2020年04期
頁碼:
6-9
欄目:
臨床研究
出版日期:
2020-08-20

文章信息/Info

Title:
Detection value of CK19 in lymph node micrometastasis of NSCLC:analysis of 90 cases
文章編號(hào):
1002-2600(2020)04-0006-04
作者:
陳新富 劉 寧 劉加夫1
福建省福州肺科醫(yī)院胸外科(福州 350000)
Author(s):
CHEN Xinfu; LIU Ning; LIU Jiafu.
Department of Thoracic Surgery,Fuzhou Pulmonary Hospital of Fujian,Fuzhou,Fujian 350000,China
關(guān)鍵詞:
非小細(xì)胞肺癌;  細(xì)胞角蛋白CK19;  淋巴結(jié)微轉(zhuǎn)移;  淋巴結(jié)清掃術(shù)
Keywords:
non-small cell lung cancer;  cytokeratin CK19;  lymph node micrometastasis;  lymph node dissection
分類號(hào):
R734.2
文獻(xiàn)標(biāo)志碼:
B
摘要:
目的 分析pT1a～bN0M0 Ia1～2期非小細(xì)胞肺癌(NSCLC)患者術(shù)后淋巴結(jié)微轉(zhuǎn)移情況、危險(xiǎn)因素,以及淋巴結(jié)清掃術(shù)的方式。方法 應(yīng)用免疫組化法檢測(cè)90例經(jīng)手術(shù)治療的孤立單發(fā)直徑≤2 cm的NSCLC患者CK19表達(dá)水平,以評(píng)估淋巴結(jié)微轉(zhuǎn)移情況,并結(jié)合臨床資料進(jìn)行分析。結(jié)果 90例患者術(shù)后常規(guī)HE染色陰性淋巴結(jié)6例(6.6%)檢出CK19陽性表達(dá)。微乳頭或?qū)嵭詾橹鞯牟±眍愋汀EA水平≥5 ng/mL的患者,術(shù)后淋巴結(jié)CK19表達(dá)顯著(P<0.05)。其中微乳頭或?qū)嵭詾橹鞯牟±眍愋褪前l(fā)生淋巴結(jié)微轉(zhuǎn)移的危險(xiǎn)因素。純磨玻璃結(jié)節(jié)術(shù)后淋巴結(jié)未發(fā)現(xiàn)微轉(zhuǎn)移灶; 部分實(shí)性磨玻璃結(jié)節(jié)術(shù)后檢出2例淋巴結(jié)微轉(zhuǎn)移。結(jié)論 Ia期NSCLC患者可發(fā)生淋巴結(jié)微轉(zhuǎn)移,微乳頭或?qū)嵭詾橹鞯牟±眍愋褪前l(fā)生淋巴結(jié)微轉(zhuǎn)移的危險(xiǎn)因素; CT影像表現(xiàn)為純磨玻璃的肺癌結(jié)節(jié)術(shù)中可避免行系統(tǒng)性淋巴結(jié)清掃; 部分實(shí)性磨玻璃結(jié)節(jié),若術(shù)中冰凍病理提示有微乳頭或?qū)嵭詾橹骰蛐g(shù)前CEA水平≥5 ng/mL應(yīng)行系統(tǒng)性淋巴結(jié)清掃。
Abstract:
Objective To analyze lymph node micrometastasis in the patients with non-small cell lung cancer(NSCLC)(pT1a-bN0M0 Ia1-2 stage,IASLC eighth edition of the TNM classification for lung cancer)after surgery,explore the risk factors of lymph node micrometastasis, and further analyze the choice of surgical procedures for stage Ia1-2 NSCLC lymph node dissection.Methods A total of 569 lymph nodes from 90 surgically treated isolated pulmonary nodules(diameter≤2 cm)were selected, the expression of CK19 was detected by immunohistochemistry and analyzed together with the clinical data.Results CK19 expression was detected in 6 cases(6.6%)of 90 patients with conventional H&E-staining negative lymph nodes after surgery.In patients with micropapillary or solid pathology type and CEA level ≥5 ng/mL, the expression of CK19 in lymph nodes was statistically different(P<0.05).Among them, micropapillary or solid pathology was a risk factor for lymph node micrometastasis.No micrometastasis were found in lymph nodes after pure Ground-Glass Opacity(pGGO)surgery; two cases of lymph node micrometastasis were detected after Part-solid GGO surgery.Conclusion Lymph node micrometastasis can occur in patients with stage Ia1-2 NSCLC.Micropapillary or solid pathology is a risk factor for lymph node micrometastasis.CT images show pure ground glass lung cancer nodules,which can be avoided during surgery.For some solid ground glass nodules, if intraoperative frozen pathology indicates micropapillary or solid components or preoperative CEA level ≥ 5 ng/mL,systemic lymph node dissection should be performed.

參考文獻(xiàn)/References:

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備注/Memo

備注/Memo:
基金項(xiàng)目:福州市科技計(jì)劃項(xiàng)目(2015-S-142-8)
更新日期/Last Update: 2020-08-20