Assessment and clinical significance of micrometastases in lymph nodes of head and neck cancer patients detected by E48 (Ly-6D) quantitative reverse transcription-polymerase chain reaction
Assessment and clinical significance of micrometastases in lymph nodes of head and neck cancer patients detected by E48 (Ly-6D) quantitative reverse transcription-polymerase chain reaction
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DOI：
10.1097/01.lab.0000083532.46536.56
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发表时间：
2003-08-01
影响因子：
5
通讯作者：
Brakenhoff, RH
中科院分区：
文献类型：
--
作者：
Nieuwenhuis, EJC;Leemans, CR;Brakenhoff, RH
淋巴结转移的存在是头颈部鳞状细胞癌（HNSCC）预后的主要决定因素。目前尚不清楚组织学上无法检测到的微转移是否也是如此。我们分析了23例HNSCC患者的456个组织学肿瘤阴性淋巴结（无pN0）和18例颈部解剖标本中有一个或两个肿瘤阳性淋巴结（pN+）的组织病理学检查。为了检测这些淋巴结中弥散性肿瘤细胞和微转移的存在，我们使用实时定量RT-PCR，将E48 （Ly-6D）转录物作为鳞状细胞特异性分子标记。将结果与组织病理检查及临床结果进行比较。pN0组23例患者中有5例（22%）淋巴结检测到E48转录本，pN+组18例患者中有10例（56%）淋巴结检测到E48转录本。在pN0组中，与e48阴性淋巴结相比，e48阳性淋巴结的存在与明显较差的病因特异性生存率显著相关。我们的结果表明，E48实时定量RT-PCR是检测HNSCC患者淋巴结微转移的一种合适的方法。此外，微转移的检测似乎与临床相关，但应在大型多中心试验中得到证实。
The presence of lymph node metastases is the major determinant for prognosis in head and neck squamous cell carcinoma (HNSCC). It is at present unknown whether the same holds true for the presence of histologically undetectable micrometastases. We analyzed 456 histologically tumor-negative lymph nodes of 23 HNSCC patients without (pN0) and 18 patients with one or two tumor-positive lymph nodes (pN+) in their neck dissection specimens at histopathologic examination. To detect the presence of disseminated tumor cells and micrometastases in these lymph nodes, we used real-time quantitative RT-PCR with E48 (Ly-6D) transcripts as a squamous cell-specific molecular marker. The results were compared with histopathologic examination and clinical outcome. E48 transcripts were detected in lymph nodes of 5 (22%) of 23 patients in the pN0 group, and in histologically negative lymph nodes of 10 (56%) of 18 patients in the pN+ group. In the pN0 group, the presence of E48-positive lymph nodes was significantly associated with a distinctly poor cause-specific survival as compared with those with E48-negative lymph nodes. Our results indicate that E48 real-time quantitative RT-PCR is a suitable method for the detection of micrometastases in lymph nodes of patients with HNSCC. Moreover, detection of micrometastases seems clinically relevant but should be confirmed in a large multicenter trial.