亚甲蓝前哨淋巴结定位在结直肠癌中的意义  

Clinical research of sentinel lymph node mapping by methyleneblue staining in colorectal cancer

作　　者：陈国星[1,2] 赖东明[1] 李英儒[1] 杨斌[1] 陈双[1] 

机构地区：[1]中山大学孙逸仙纪念医院胃肠外科,广州510120 [2]清远市人民医院普通外科

出　　处：《岭南现代临床外科》2009年第6期419-421,共3页Lingnan Modern Clinics in Surgery

基　　金：广东省科技计划项目(2007B031513010)

摘　　要：目的探讨亚甲蓝在结直肠癌前哨淋巴结(sentinel lymph node,SLN)新鲜离体标本定位方法的可行性及临床意义。方法以1%亚甲蓝对49例新鲜结直肠癌离体标本作SLN定位,标本染色后10分钟内先蓝染的第1-4个淋巴结视为SLN。所有标本均行常规石蜡切片,阴性的SLN再行多层切片,观察SLN对区域淋巴结转移的预测价值。结果 49例病人中有47例检出SLN,检出率是95.92%,共获得SLN 98枚,平均每例2.09枚(1～4枚)。SLN预测区域淋巴结转移的准确率为97.87%;特异性为95.83%;敏感性为94.45%;假阴性率为3.70%。结论以1%亚甲蓝作结直肠癌新鲜离体标本SLN定位简单、易行、可靠。SLN转移与否,可基本能反映区域淋巴结的转移状况。多层切片可降抵SLN的假阴性率。Objective To investigate the feasibility and clinical significance of making ex vivo sentinel node mapping in colorectal cancer by utilizing methylene blue. Methods Fortynine ex vivo specimens were made by 1% methylene blue staining. The first 1 to 4 blue lymph nodes were usually seen within 10 minutes of dye injection and thev were defined as SLN. All specimann were submitted to pathological examination. If the sentinel lymph node were negative, that would add another ten sections and made routine pathological examination again.Results Sentinel lymph node mapping was successful in 95.92% （47/49）, there were 98 SLNs at all,average 2.09 （1-4）per specimen. Therefore, accuracy rate was 97.87%, specificity was 95.83%, sensitivity was 94.45%, and false negatives rate was 4.17%. Conclusion SLN could predict the metastasis condition of regional lymph node basically.

关 键 词：直肠癌 前哨淋巴结 多层切片 

分 类 号：R735.3[医药卫生—肿瘤]