中老年人胃癌前哨淋巴结术中定位的临床研究  

Clinical value of intraoperative sentinel lymph node mapping and detection in gastric cancer

作　　者：张研[1] 张海山[1] 任辉[1] 钟艳萍[2] 冯红[3] 

机构地区：[1]吉林大学中日联谊医院基本外科,吉林长春130033 [2]吉林大学中日联谊医院病理科 [3]长春市儿童医院

出　　处：《中国老年学杂志》2004年第12期1151-1153,共3页Chinese Journal of Gerontology

摘　　要：目的　探讨胃癌前哨淋巴结 (SLN)术中定位和检测应用的可行性及其预测胃癌淋巴转移的准确性。方法　应用 1 %亚甲蓝染色剂 ,对 2 8例 (T1、T2期 )胃癌病人进行术中SLN定位 ,切除蓝染淋巴结〔平均每例病人 (2 6± 1 7)个〕 ,随后对患者均行胃癌扩大根治术。SLNs和非前哨淋巴结 (nSLNs)均行苏木精 伊红 (HE)染色。结果　 2 8例中有 2 7例 (96 4% )成功检出SLN ,1 0例患者有淋巴结转移 ,其中 6例存在SLN及n SLN转移 ,3例存在SLN转移 ,1例只有n SLN转移。由SLN状态预测胃周淋巴结转移情况的敏感性为 90 % (9/ 1 0 ) ,特异性为 1 0 0 % (1 7/ 1 7) ,准确率为 96 3 % (2 6/ 2 7)。T1组 (1 2例 )与T2组 (1 6例 )敏感性分别为 1 0 0 %和 88%。结论　应用亚甲蓝染色剂对胃癌SLN定位检测成功率高 ,SLN状态 ,尤其是T1期胃癌 ,能够准确预测胃癌患者的淋巴结转移状况。Objective To investigate the feasibility and its accuracy of intraoperative sentinel lymph node (SLN) mapping and detection in predicting the lymph node status in patients with gastric carcinoma.Methods SLN mapping was performed in 28 patients with T1 and T2 gastric carcinomas with 1% methylthioninium chloride, and the blue stained nodes were resected 〔(2.6±1.9) nodes per patient〕. Then, gastrectomy with extended lymphadenectomy was performed. Both SLNs and non SLNs were subjected to histological examination with hematoxylin eosin. Results SLNs were identified in 27 of 28 patients (success rate, 96.4%). Of these 27 patients, 10 had lymph node metastases in SLNs or non SLNs, 6 in both SLNs and NON SLNs, 3 in SLNs alone and 1 in non SLNs alone. The sensitivity of the SLN status in the diagnosis of the lymph node metastases status of the patients was 90% (9/10), specificity was 100% (17/17) and accuracy was 96.3% (26/27). Sensitivity was 100% in the T1 group ( n =12) and 88% in the T2 group ( n =16). Conclusions SLN mapping and detection using methylthioninium chloride can be performed with a high success rate, and the SLN status can predict the lymph node metastases status with a high degree of accuracy, especially in patients with T1 gastric carcinoma.

关 键 词：胃癌 前哨淋巴结 定位 手术 

分 类 号：R735.2[医药卫生—肿瘤]