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肿瘤微转移的相关研究及AE1/AE3在其中的价值
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Abstract:
在人口老龄化的全球大背景下,恶性肿瘤的发病率和致死率也逐年上升,在恶性肿瘤病灶局限、未发生转移时行医疗干预往往可以取得较好的疗效,因此早期发现恶性肿瘤或发现后进行精准有效的评估及干预显得尤为重要。免疫组化法(Immunohistochemistry, IHC)利用特异性的抗原抗体染色在鉴别肿瘤微转移中发挥着重要作用,有助于识别出常规病理切片HE染色未能识别的转移病灶;AE1/AE3主要表达于上皮细胞,常被用作诊断上皮性肿瘤转移的分子标记物,HE染色可见肿瘤转移的淋巴结经AE1/AE3标记均为阳性,HE染色阴性的淋巴结中也可见AE1/AE3的部分表达,且在常规病理检测为阴性的淋巴结中,AE1/AE3阳性患者往往比阴性患者具有更高的复发率和更低的5年生存率。因此常规病理联合检测AE1/AE3表达有助于评估患者肿瘤分期和判断预后,进而能对高危患者进行早期干预,提高患者生存期。本综述主要从恶性肿瘤淋巴结转移、常用的肿瘤转移检测方法以及分子标记物AE1/AE3在诊断淋巴结微转移中的作用等方面入手,为诊断恶性肿瘤淋巴结微转移可采用的方法和精准识别提供理论依据。
Under the global background of aging population, the incidence and mortality of malignant tumors are increasing year by year. Medical intervention can often achieve good results when the focus of malignant tumors is limited and has not metastasized, so it is particularly important to find malignant tumors early or make accurate and effective evaluation after discovery. Immunohistochemistry (IHC) plays an important role in differentiating tumor micrometastasis by using specific antigen-antibody staining, which is helpful to identify metastatic lesions that can not be identified by HE staining in conventional pathological sections. AE1/AE3 is mainly expressed in epithelial cells, and is often used as a molecular marker to diagnose epithelial tumor metastasis. HE staining shows that all lymph nodes with tumor metastasis are positive by AE1/AE3 labeling, and some AE1/AE3 expression can also be seen in lymph nodes with negative HE staining. In lymph nodes with negative routine pathological examination, patients with AE1/AE3 positive often have higher recurrence rate and lower 5-year survival rate than patients with negative tumor. Therefore, the combined detection of AE1/AE3 expression by routine pathology is helpful to guide the diagnosis and prognosis of patients, and is beneficial to the early intervention of high-risk patients, thus improving the survival time of patients. This review mainly focuses on lymph node metastasis of malignant tumor, commonly used methods for detecting tumor metastasis and the role of molecular markers AE1/AE3 in the diagnosis of lymph node micrometastasis, so as to provide theoretical basis for the methods and accurate identification of lymph node micrometastasis of malignant tumor.
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