Research Of CK19 MRNA And VEGF-C In Sentinel Lymph Node Detection To Early Stage Cervical Cancer

[Objective]The thesis aims to detect the expressions of CK19 mRNA in sentinel lymph nodes of early stage cervical cancer and the level of serum VEGF-C,in order to explore the relativity of VEGF-C and CK19 mRNA with micro-metastases in sentinel lymph nodes of early stage cervical cancer and the clinical significance.[Method]1.We selected 30 initial patients who underwent radical hysterectomy and lymphadenectomy at the Department of Gynecological Oncology in The Third Affiliated Hospital of Kunming Medical College(Yunnan Province Tumor Hospital) from Dec,2007 to Dec,2008.Based on the inter-national Federation of Gynecology and Obstetrics(FIGO) staging criteria for cervical cancer,patients included 30 cases of stageⅠa-Ⅱa.And 20 hysteromyoma patients was control group.2.Sentinel lymph nodes were identified with radioactivity isotope and methylene blue.Expression of CK19 mRNA was detected by RT-PCR in sentinel lymph node of the early stage cervical cancer.The level of serum VEGF-C was examined by ELISA in the early stage cervical cancer.The connection was analyzed between CK19 mRNA and VEGF-C and between them and clinic pathologic features of patients.[Results]1.55 Sentinel lymph nodes were examined in 30 cases of cervical cancer. Among them,histopathologic examinations demonstrated the presence of metastases in 8 sentinel lymph nodes of 8 patients,and the positive rate is 14.5%.However,RT-PCR detected the expression of CK19 mRNA in 18 sentinel lymph nodes of 12 patients were positive,and the positive rate is 32.7%.RT-PCR identified the expressions of CK19 in 10(21.3%) sentinel lymph nodes were positive among 47 sentinel lymph nodes without metastases confirmed by histopathologic examinations.Compared histopathology with RT-PCR in detection of positive rate of sentinel lymph nodes,there were significant difference in statistics(P＜0.05).2.Expression of CK19 mRNA in sentinel lymph nodes was significantly related to clinical histopathology type(P＜0.05).Expression of CK19 mRNA in sentinel lymph nodes was not significantly associated with other characteristics such as age,clinical stage,differentiation grade,tumor size,lymph vascular space invasion and deep stromal invasion(P＞0.05).Expression of CK19 mRNA in sentinel lymph nodes was positively related to adenocarcinoma.3.Average value of serum VEGF-C in cervical cancer and hysteromoma were 5641pg/ml and 4925pg/ml respectively,which was significant difference between two groups(P＜0.05). 4.Average value of serum VEGF-C in CK19 positive group and CK19 negative group were 6116pg/ml and 5327pg/ml respectively.Serum VEGF-C were significant difference between two groups(P＜0.05).5.Serum VEGF-C was positively associated with CK19(r=0.431).[Conclusions]1.Compared to histopathology,detection of CK19 mRNA can significantly find the detection rate of micro-metastases in sentinel lymph nodes by RT-PCR.2.The increase of serum VEGF-C was positively related to micro-metastases in sentinel lymph nodes.3.The increase of serum VEGF-C may be a sign from cervical cancer to lymph nodes micro-metastases.