Establishment of rapid molecular diagnoses of micrometastases of sentinel lymph node and its clinical application

我们的研究表明：1。前哨淋巴结（SLN）的识别可作为消化器官癌手术或淋巴结清扫减容时的扩张指标。SLN微转移的诊断; 3.外科手术中快速基因诊断方法的建立;评价SLN对术后并发症的影响.以前哨淋巴结（sentinel lymph node，SLN）的识别作为消化道肿瘤手术时淋巴结扩大或淋巴结清扫减少的指标，对52例胃癌中淋巴结转移阴性的30例进行常规病理诊断，并对其中30例进行微转移情况的评估。结论：1.在判断#7淋巴结是否可作为SLN时，以#7淋巴结可反映其他2组淋巴结的转移情况为标准，得到的结果可反映其他2组淋巴结的转移情况（假阴性率：16.7%，准确率：88.9%）.前哨淋巴结微转移的诊断 ...更多信息 采用HE染色、免疫组化、RT-PCR等方法进行检测。然后，除了仅使用常规HE染色方法进行评估之外，还成功地提高了通过免疫组织化学和RT-PCR方法进行联合评估的SLN转移阳性病例的检测率（SLN鉴定率：95→ 98%; Int. J. Oncol. 2000年）。开发了外科手术中的快速分子诊断方法，使用常规RT-PCR方法获得基因诊断的诊断结果需要约8小时。尽管目前通过改进RNA取样过程和引入真实的时间PCR获得诊断结果，但我们成功地缩短了约75分钟和时间。当从新的RNA取样过程到cDNA组成和通过实时PCR方法进行检测的技术正在建立时，推测将在大约50分钟内获得诊断结果。对52例胃癌患者中临床Ⅰ、Ⅱ期行根治性切除术的28例#7淋巴结转移情况（RT-PCR法诊断）进行分析。结果表明，7号淋巴结转移阳性者预后较阴性者差。少

Our study has revealed that ; 1. Identification of sentinel lymph node (SLN) used as index of expansion at time of operation of digestive organ cancer or reduction of lymph nodes dissection, 2. Diagnosis of micrometastases of SLN, 3. Development of rapid gene-diagnosis method while surgical operation, 4. Evaluation of influence of SLN affection on prognosis.1. Identification of sentinel lymph node (SLN) used as index of expansion at time of digestive organ cancer operation, or reduction of lymph nodes dissection.The conventional pathological diagnosis estimated the micrometastases situation of 30 cases that were lymph node metastases negative among 52 stomach cancer cases. The result in which #7 lymph node may reflect other 2 group lymph node may reflect other 2 group lymph nodes metastases situations in evaluation whether #7 lymph node may serve as SLN was obtaind (rate of false negative : 16.7 % and rate of accuracy : 88.9 %).2. Diagnosis of micrometastases of SLNThe hematoxylin-eosi … More n (HE) staining, the immunohistochemistry, and RT-PCR method have been examined. Then, it succeeded in raising the rate of detection of the cases, that is positive of metastases of SLN using together evaluation by the immunohistochemistry and RT-PCR method in addition to evaluation only using the conventional HE staining method (16 rate of SLN identification : 95→98 % ; Int. J. Oncol. 2000).3. Development of rapid molecular diagnosis method while surgical operation.It had required for obtaining a diagnostic result of the gene diagnosis using the conventional RT-PCR method for about 8 hours. We succeeded in shortening about 75 minutes and time, although a diagnostic result is obtained by an improvement of a RNA sampling process and introduction of real time PCR at present. When the technique from a new RNA sampling process to cDNA composition and delection by the real-time PCR method is now under establishment, it is presumed that it will be about 50 minutes obtaining a diagnostic result.4. Evaluation of influence SLN affects prognosisAnalysis about the metastases situation (it diagnoses in RT-PCR method) of #7 lymph node was performed about 28 cases in which were the clinical stage I and II performed curability A resection among 52 stomach cancer cases. It revealed that the cases of #7 lymph node metastases positive become poor prognosis compared with negative cases. Less