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目的探讨乳腺癌前哨淋巴结(SLN)组织中人乳腺珠蛋白(hMAM)的表达及其临床意义。方法 32例可手术的原发性乳腺癌患者,在乳腺癌根治性手术中均行肿块周围或乳晕周围注射亚甲蓝成功定位SLN,按常规行腋窝淋巴结清扫,术后对SLN和非SLN行常规病理学检查,并进一步采用RT-PCR和Western Blot检测SLN冷冻组织中hMAM的表达。结果 32例SLN常规病理检查结果6例阳性SLN,阳性率为18.75%,1例假阴性,假阴性率为14.28%。RT-PCR和Western Blot检测hMAM,阳性SLN分别为12例和9例,阳性率分别为37.50%和28.13%,无假阴性。两者与病理检查结果相比差异均有显著性(P<0.05)。结论 SLN定位后检测SLN中hMAMmRNA的阳性表达,相对于SLN定位后仅行常规病理检查,明显提高了乳腺癌阳性SLN的准确率,降低假阴性率。故hMAMmRNA可单独作为标志物来检测乳腺癌SLN微转移。
Objective To investigate the expression of human mammary gland globin (hMAM) in sentinel lymph node (SLN) tissues of breast cancer and its clinical significance. Methods Twenty-two patients with operable primary breast cancer who underwent radical surgery for breast cancer underwent local injection of methylene blue around the tumor or areola around the SLN. Conventional axillary lymph node dissection was performed. SLN and non-SLN Routine pathological examination was performed. The expression of hMAM in SLN frozen tissues was further detected by RT-PCR and Western Blot. Results Sixteen cases of positive SLN were detected by routine pathological examination in SLN. The positive rate was 18.75%. One case had false negative and the false negative rate was 14.28%. RT-PCR and Western Blot detection hMAM positive SLN were 12 cases and 9 cases, the positive rates were 37.50% and 28.13%, no false negative. There was a significant difference between the two and pathological findings (P <0.05). Conclusion The positive expression of hMAM mRNA in SLN after SLN localization was detected. Compared with SLN, the routine pathological examination was performed only after SLN localization, which significantly improved the accuracy of breast cancer positive SLN and decreased the false negative rate. Therefore, hMAM mRNA can be used alone as a marker to detect breast cancer SLN micrometastases.