cn0甲状腺乳头状癌中央区淋巴结微转移的初步研究.docVIP

cN0甲状腺乳头状癌中央区淋巴结微转移的初步研究 　　[摘要] 目的 探?cN0甲状腺乳头状癌中央区淋巴结的微转移情况，探讨逆转录聚合酶链反应（RT-qPCR）技术对诊断淋巴结微转移灶的价值，并筛选微转移的临床病理高危因素。 方法 选取2012年11月～2014年3月浙江省肿瘤医院收治的cN0甲状腺乳头状癌患者48例，对从中取到136个病理证实无转移的中央区淋巴结分别用免疫组化和RT-qPCR检测CK19的表达情况。将患者的各项临床病理相关因素作为自变量，以淋巴结微转移因素作为因变量，应用二分类变量Logistic回归模型进行多因素分析，以期发现微转移可能的高危因素。 结果 免疫组化检测CK19为15.44%（21/136），RT-qPCR法的阳性检出率为82.35%（112/136）。RT-qPCR 法与免疫组化法比较具有显著差异。Logistic回归模型中筛选出肿瘤甲状腺包膜侵犯是cN0甲状腺乳头状癌中央区淋巴结微转移的危险因素。 结论 应用RT-qPCR检测CK19表达，可提高对甲状腺癌的淋巴结微转移阳性检出率。肿瘤甲状腺包膜侵犯是淋巴结微转移的独立危险因素。 　　[关键词] 甲状腺肿瘤；甲状腺乳头状癌；细胞角蛋白19；微转移；聚合酶链反应 　　[中图分类号] R736.1 [文献标识码] A [文章编号] 1673-9701（2017）02-0001-04 　　Preliminary study of lymph node micrometastasis in the central compartment of cN0 papillary thyroid carcinoma 　　HAN Chun1 WANG Kejing1 ZHANG Gu2 XU Jiajie1 ZHENG Weihui1 　　1.Department of Head and Neck Surgery， Zhejiang Cancer Hospital， Hangzhou 310022， China； 2.Department of Pathology， Zhejiang Cancer Hospital， Hangzhou 310022， China 　　[Abstract] Objective To investigate the micrometastasis of lymph node in the central compartment of cN0 papillary thyroid carcinoma， to explore the value of reverse transcription polymerase chain reaction（RT-qPCR） in the diagnosis of lymph node micrometastasis， and to screen the clinical pathological risk factors of micrometastasis. Methods A total of 48 patients with cN0 thyroid papillary carcinoma who were admitted to Zhejiang Cancer Hospital from November 2012 to March 2014 were enrolled in this study. The expression of CK19 was detected by immunohistochemistry and RT-qPCR in 136 lymph nodes in the central zone collected from them， which was pathologically confirmed without metastasis. The clinicopathological factors of patients were taken as independent variables， and lymph node micrometastasis factors were taken as the dependent variables. Multivariate analysis was applied by binary variables Logistic regression model， so as to explore the possible risk factors of micrometastasis. Results CK19 was detected by immunohistochemistry in 15.44