RT-PCR Detection Micrometastasis of Sentinel Lymph Node in Non-small Cell Lung Cancer and Its Clinical Significance
|School||Huazhong University of Science and Technology|
|Keywords||non-small cell lung cancer sentinel lymph node micrometastasis Cytokeratin reverse-transcriptasepolymerasechainreaction|
Objective: To investigate the feasibility and clinical significance of RT-PCR todiagnosemicrometastasisofsentinellymphnodeinnon-smallcelllungcancer.Methods: 24 cT1N0M0/cT2N0M0 non-small cell lung cancer patients wereintraoperatively used sentinel lymph node biopsy, RT-PCR was applied to detect theexpression of CK19mRNA in sentinel lymph node to determine the presence ofmicrometastasis, pathological and clinical analysis was compared with theconventionalHEstainingresults.Results:24 cT1N0M0/cT2N0M0 non-small cell lung cancer cases (15 squamous cellcarcinoma cases, 9 adenocarcinoma cases), intraoperatively obtained 146 lymphnodes(average 6 to 8),including 67 Sentinel lymph nodes, and 79 non-sentinel lymphnodes. SLN sensitivity was 100%, accuracy was 91.7%, and false negative rate was0%. 3 Sentinel lymph nodes were detected micrometastasis by conventionalpathological HE staining (positive rate 3.0%, 2/67), 21 sentinel lymph nodesCK19-positive by RT-PCR (positive rate 31.3%, 21/67). RT-PCR for detection ofpositive sentinel lymph node micrometastasis was 31.3%, significantly higher thanconventional pathological HE staining positive rate 3.0%, the difference wasstatisticallysignificant(P<0.05).Metastasiswasn’tdetectedin79non-sentinellymphnodes.Conclusions: Combined sentinel lymph node biopsy and RT-PCR technique cansignificantly improve the non-small cell lung cancer detection rate of lymph nodemicrometastasis. This method can be accurate TNM staging non-small cell lungcancer and guide adjuvant therapy to improve stageⅠnon-small cell lung cancersurvival.