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目的探讨病理诊断区域淋巴结阴性(pN0)大肠癌根治切除后早期复发与淋巴结微转移的相关性。方法应用逆转录聚合酶链反应技术,对32例pN0大肠癌患者192枚根治术后病理诊断阴性区域淋巴结的细胞角蛋白20(CK-20)mRNA进行检测,诊断淋巴结微转移。术后1年内对患者进行复查,比较pN0淋巴结CK20 mRNA表达与否肿瘤患者复发率的差异。结果13例患者(40.6%)29枚(15.1%)淋巴结检测到CK20 mRNA的表达,诊断为淋巴结微转移,TNM分期由Ⅰ~Ⅱ期上调为Ⅲ期;9例(28.1%)患者肿瘤复发,其中淋巴结微转移7例,无转移者2例,两者比较差异有显著性(校正χ2=5.7,P<0.05)。结论pN0期患者手术后肿瘤的早期复发与淋巴结微转移有关。
Objective To investigate the correlation between early recurrence and lymph node micrometastasis after radical resection of pathologically diagnosed regional lymph node-negative (pN0) colorectal cancer. Methods Reverse transcription polymerase chain reaction (RT-PCR) was used to detect the cytokeratin 20 (CK-20) mRNA in 192 patients with pN0 colorectal cancer who had undergone pathological diagnosis. The lymph node micrometastases were diagnosed. The patients were reviewed within 1 year after operation, and the differences in the recurrence rate of CK20 mRNA in pN0 lymph nodes were compared between the two groups. Results The expression of CK20 mRNA was detected in 29 (15.1%) lymph nodes from 13 patients (40.6%). The lymph node micrometastasis was diagnosed. The TNM stage was up to stage Ⅲ from stage Ⅰ to Ⅱ. Nine patients (28.1% There were 7 cases of lymph node micrometastasis and 2 cases of no metastasis, the difference was significant (χ2 = 5.7, P <0.05). Conclusion The early recurrence of tumor in patients with pN0 after surgery is related to lymph node micrometastasis.