胃癌前哨淋巴结定位活检技术的临床应用及意义  

Clinical Application and Significance of Sentinel Lymph Node Biopsy in Gastric Cancer

作　　者：尤建权[1] 马利林[1] 朱建伟[1] 孙锦卫[1] 于嘉伟[1] 刘建明[1] 

机构地区：[1]南通大学附属医院普外科,226001

出　　处：《实用癌症杂志》2008年第5期503-506,共4页The Practical Journal of Cancer

基　　金：江苏省南通市科技局资助项目(S2006021)

摘　　要：目的探讨前哨淋巴结活检技术在胃癌早期手术治疗中的应用价值。方法60例胃癌术中亚甲蓝定位活检前哨淋巴结(SLN),术后行常规HE病理和免疫组化检查。结果60例中56例检出SLN,检出率为93.3%。HE检查发现49枚(24)例SLN转移,由SLN组织学状态预测胃癌区域淋巴结转移状况的准确率为76.8%,敏感性为64.9%,特异性为100.0%,假阴性率为35.1%,而早期胃癌中准确率为93.9%,敏感性88.9%。免疫组化检查结果发现有67枚(32例)SLN转移。结论SLN能较准确反映早期胃癌的淋巴结转移状况,为进一步行前瞻性研究提供了理论依据,也为早期胃癌制定合理的手术方案提供了依据。免疫组化法对SLN转移的检测较HE有更高的敏感性。Objective To investigate the clinical value of sentinel lymph nodes （SLNs） biopsy in gastric cancer. Methods 60 patients with gastric cancer were treated by surgical resection. During operation, sentinel nodes were located by injection of the methylene blue. The Sentinel lymph nodes were then removed for pathological studies using HE and immunohistochemical method. Results Of the 60 patients,SLNs were detected in 56 （93.3 % ）. 49 SLNs were detected in 24 patients by HE staining. The accuracy, sensitivity, specificity, and false negative rate of SLN status in diagnosis of node metastasis were 76.8% ,64.9 % , 100.0% and 35.1% , respectively. The accuracy and sensitivity for early gastric cancer were 93.9% and 88.9% , respectively. 67 SLNs were detected in 32 patients by immunohistochimical method. Conclusion Sentinel node biopsy could provide accurate information for node metastasis in early gastric carcinoma. Immunohistochemical technology is more sensitivity than HE in the exploration of lymph node metastasis.

关 键 词：前哨淋巴结 前哨淋巴结活检 胃癌 

分 类 号：R730.4[医药卫生—肿瘤] R735.2[医药卫生—临床医学]