作　　者： (尹培）; (曹莉明）; (游志鑫）; (柴鹏）; (郝美静）; (王浩）;

机构地区： 邯郸市中心医院核医学科,河北邯郸056001

出　　处： 《临床误诊误治》 2017年第8期97-100,共4页

摘　　要： 目的探讨乳腺癌前哨淋巴结(sentinel lymph node,SLN)中血管内皮生长因子(vascular endothelial growth factor,VEGF)在不同检查方法的表达及临床意义。方法对2011年10月—2015年10月在邯郸市中心医院行手术治疗的原发性乳腺癌47例,术前均于乳晕周围注射^(99m)Tc-硫胶体(^(99m)Tc-SC)对SLN定位,实行乳腺癌改良根治术,术中利用γ探测仪进行SLN探测,术后所有标本均行常规病理检查,并通过免疫组织化学染色和逆转录-聚合酶链反应(RT-PCR)方法检测VEGF表达情况。结果 47例术中共切检SLN 105枚,常规病理检查检出SLN转移85枚。VEGF表达常规病理检查检出SLN转移明显高于常规病理检查检出无SLN转移,二者比较差异具有统计学意义(P<0.05)。Spearman秩相关性分析显示VEGF阳性表达与淋巴结转移具有一定相关性(P<0.05)。常规病理检查方法及VEGF免疫组织化学染色、RT-PCR检测对乳腺癌SLN转移检出率总体比较差异具有统计学意义(P<0.05),常规病理检查方法对乳腺癌SLN转移检出率均低于VEGF免疫组织化学染色和RT-PCR检测,差异均有统计学意义(P<0.05)。结论 SLN活组织病理检查对判断乳腺癌SLN是否转移具有重要临床意义。临床上对乳腺癌患者应在常规病理检查同时进行免疫组织化学染色及RT-PCR等检查,以提高SLN微转移灶的检出率。 Objective To investigate expression and clinical significance of vascular endothelial growth factor （VEGF） in sentinel lymph nodes （SLNs） tissues of patients with breast cancer by different detection methods.Methods A total of 47 patients with primary breast cancer undergoing surgery during October 2011 and October 2015 were recruited in this study, and all patients were injected 99mTc-sulfur colloid （99mTc-SC） around areola papillaris to locate SLNS before the operation, and modified radical mastectomy was performed for all patients, and SLNs were detected by γ detector during operation.Routinely pathological examination was performed for all patients, and VEGF expressions were detected by immunohistostaining and reverse transcription-polymerase chain reaction （RT-PCR） methods.Results In 47 patients, 105 SLNs were detected, and 85 SLNs were SLNS metastasis by routinely pathologic examination.VEGF expression levels in SLNs metastasis cases were significantly higher than those in non SLNs metastasis cases by routinely pathological examination （P〈0.05）.Spearman rank correlation analysis showed that VEGF positive expression was associated with lymph node metastasis （P〈0.05）.The differences in detection rates of SLNS metastasis by routinely pathological examination, VEGF immunohistostaining and RT-PCR methods were statistically significant （P〈0.05）, and the detection rate of SLNS metastasis in breast cancer by routinely pathological examination was significantly lower than those by VEGF immunohistostaining and RT-PCR methods （P〈0.05）.Conclusion SLNs living tissue of pathologic examination has clinical significance in judgement of SLNS metastasis in breast cancer, and therefore clinicians should simultaneously use immunohistostaining and RT-PCR methods on the basis of routinely pathological examination in order to improve the detection rate of SLNS micrometastases.

关 键 词： 乳腺肿瘤 前哨淋巴结活组织检查 血管内皮生长因子