| DukesB期大肠癌前哨淋巴结微转移检测的临床意义 |
| Alternative Title | Detection of Sentinel Lymph Node Micrometastasis in DukesB Colorectal Carcinoma patients and its Clinical Significance
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| 王涛 |
| Thesis Advisor | 郭天康
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| 2009-05-14
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| Degree Grantor | 兰州大学
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| Place of Conferral | 兰州
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| Degree Name | 硕士
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| Keyword | 大肠癌
细胞角蛋白
端粒酶
前哨淋巴结
微转移
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| Abstract | 目的 探讨大肠癌前哨淋巴结（sentinel lymph node,SLN）微转移(micrometastasis,MM)的检测方法及其临床意义。方法 2004年9月至2005年7月在甘肃省人民医院，前瞻性研究64例行根治性手术的DukesB期大肠癌病人，对其中61例定位成功的122枚SLN应用常规HE染色联合免疫组化SP法检测其前哨淋巴结中细胞角蛋白20（CK20）及端粒酶的表达，随访满3年，记录病人的临床病理参数和生存资料，分析其相关性。结果 (1) 61例有6例病人9枚SLN经常规HE检测阳性。（2）免疫组化法有27.3%(15/55)患者其SLN存在CK20阳性;21.8%(12/55)的病人的SLN存在端粒酶阳性表达。（3）两者联合检测微转移检出率为38.2%(21/55)。（4）DukesB期SLNMM(+)病人癌复发转移率明显高于同期SLNMM(-)组(P<0.05),生存率则降低(P<0.05),与DukesC期对比，差异无统计学意义;SLNMM(-)组的复发转移率、生存率与同期DukesC期患者对比，有统计学意义（P<0.05）。结论：免疫组化法联合检测端粒酶和CK20可提高DukesB期大肠癌SLNMM的检出率;并且对于明确大肠癌患者Dukes分期，指导术后合理的辅助治疗和预后判断有重要的临床意义。 |
| Other Abstract | Objective To investigate the detection of sentinel lymph node micrometastasis(SLNMM) and its clinical significance in these patients. Methods In a prospective study,122 SLNs were searched and examined successfully in 61 among 64 cases of DukesB colorectal carcinoma,using the immunohistochemical(IHC) staining to detect cytokeratin20(CK20) and telomerase in proper order,while the SLNs were negative by routine hematoxylin and eosin(HE) staining.Following up at least 3 years,memorized these patients’ clinical pathological parameters and survival numerical data, and analysis the dependablity. Results 9 SLNs of 6 cases were postive by HE staining;27.3%(15/55) in cases,which were negative by HE staining, were CK20 postive expression by IHC; Micrometastasis was also detected in12cases(21.8%,12/55) byIHC anti-telomerase staining.Combining the two methods can improve the micrometastasis rate as 38.2%(21/55) (P<0.05);The percent of carcinoma recurrence or metastasis for the DukesB patients with SLNMM(+) was significantly higher than that for the patients with SLNMM(-)(P<0.05),but the survival percent for the patients with SLNMM(+) was significantly lower than that for the patients with SLNMM(-).However,compared with 45 DukesC patients,the percents were no significant difference.In contrary,the percents of recurrence or metastasis and survival between DukesC patients and SLNMM(-)DukesB patients were significantly different(P<0.05).Conclusion Combining examination of immunohistochemical anti-CK20 and anti-telometase staining can improve the detection rate of SLNMM in DukesB colonrectal carcinoma patients, and it is of important clinical significance for staging Dukes, selection of adjuvant treatment and evaluation of prognosis in patients with colcrectal carcinoma. |
| URL | 查看原文
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| Language | 中文
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| Document Type | 学位论文
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| Identifier | https://ir.lzu.edu.cn/handle/262010/224159
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| Collection | 学院待认领
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| Affiliation | 临床医学院
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Recommended Citation
GB/T 7714 |
王涛. DukesB期大肠癌前哨淋巴结微转移检测的临床意义[D]. 兰州. 兰州大学,2009.
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