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作 者:赵学飞[1] 郑勇斌[1] 童仕伦[1] 甘宏发[1] 何小波[1] 刘克杰[1] 曹峰瑜[1]
出 处:《临床外科杂志》2011年第4期235-237,共3页Journal of Clinical Surgery
基 金:湖北省自然科学基金资助项目(编号:2009CDB290)
摘 要:目的 探讨强光触摸法和亚甲蓝染色法获取淋巴结对进展期胃癌术后TNM分期的影响.方法 回顾性研究107例胃癌根治性手术切除标本分别使用强光触摸法与亚甲蓝染色法获取淋巴结,并与术后病检结果对比分析,探讨不同方法所获取的淋巴结数量及对患者TNM分期迁移的影响.结果 107例胃癌标本共获取淋巴结3520枚,其中阳性转移淋巴结610枚.由强光触摸法获取2622枚,阳性转移的淋巴结数目为449枚.亚甲蓝染色法获取淋巴结898枚;阳性转移淋巴结161个.本组107例胃癌患者,单独行强光触摸法导致TNM分期迁移43例,其中ⅡA期迁移至ⅡB期1例,ⅡB期迁移至ⅢA期21例,ⅢB期迁移至ⅢC期21例,分期迁移率为40.2%.结论 单独强光触摸法获取淋巴结,对于直径较小淋巴结存在漏检,可导致TNM分期迁移.亚甲蓝染色联合强光触摸法获取淋巴结可以提高淋巴结总数量及阳性转移淋巴结数量,减少分期迁移,使TNM分期更准确,有助于指导临床治疗.Objective To investigate the effect of lymph nodes detection by methylene blue staining and light touch method on the TNM classification in advanced gastric cancer. Methods Lymph nodes from 107 gastric tumor patients who underwent radical gastreetomy were detected for metastasis by methylene blue staining and light touch method. The results were compared with those on the pathological examination. Results The total number of the lymph nodes resected was 3520 ,among which,610 lymph nodes were found to have metastasis. A total of 2622 lymph nodes were measured by the light touch method and 449 lymph nodes were seen to develop metastasis. 898 lymph nodes were suhjected to methylene blue staining and the results revealed 161 metastatic lymph nodes. In the 107 cases of gastric earicer,the light touch method alone led to TNM stage migration in 43 cases,of which 1 case migrated from Ⅱ A to Ⅱ B,21 from Ⅱ B to llIA and 21 from Ⅲ B to ⅢC. The migration rate was 40.2%. Conclusion Small lymph nodes may be missed when the light touch method alone is adopted,which results in the TNM stage migration. Methylene blue staining in combination with the light touch method can reduce the stage migration, make the TNM stage more accurate and therefore help guide the clinical treatment.
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