前哨淋巴结检测对胃癌淋巴结转移的预测价值  

Predictive value of sentinel lymph node in gastric cancer

作　　者：陶锋[1,2] 许国权[1,2] 王松祥[1,2] 吕杰青[1,2] 傅燕萍[1,2] 单水阳[1,2] 

机构地区：[1]绍兴市人民医院 [2]浙江大学绍兴医院,浙江绍兴312000

出　　处：《实用肿瘤杂志》2011年第5期500-502,共3页Journal of Practical Oncology

摘　　要：目的探讨前哨淋巴结(SLN)在不同部位和不同浸润深度胃癌中定位检测对淋巴结转移的预测价值。方法使用亚甲蓝多点注射对90例胃癌患者行前哨淋巴结术中标识活检,5-10分钟内,在胃周可找到蓝染淋巴结,即SLN,将其送病理切片,随后行D2或D2以上手术。胃标本及其余胃周淋巴结行常规病理检查。结果 90例中88例检出SLN,检出率97.8%。88例SLN中,SLN预测胃周淋巴结转移的敏感性86.2%(50/58),准确性90.9%(80/88),特异性100.0%(30/30),假阴性率13.8%(8/58)。同时,SLN预测胃周淋巴结转移的敏感性和准确率随胃癌浸润深度的增加呈降低趋势,随胃癌部位按L区、M区、U区的顺序而呈降低趋势。结论亚甲蓝多点注射是一个操作方便、结果可靠的检测胃癌前哨淋巴结淋巴结的方法,早期胃癌SLN的敏感性、准确率较高。L、M区胃癌SLN的敏感性、准确率较U区更高。Objective To identify the predictive value of sentinel lymph node（SLN） in gastric cancer of different regions and tumor invasion depth. Methods Ninty cases of gastric cancer were multi-point injected with methylene blue dye,and the blue-stained nodes,named SLNs searched in 5-10 minutes,were removed for intraoperative biopsy.All the included patients underwent D2 or D3 gastrectomy.The resected specimens and unstained nodes were sent for pathological examination. Results Of the total 90 patients,SLNs identified in 88 patients（97.8%）.Among these patients of SLN detected,the sensitivity,accuracy,specificity and false-negative rate were 86.2%（50/58）,90.9%（80/88）,100.0%（30/30） and 13.8%（8/58）,respectively.The sensitivity and accuracy were decreased with the increasing depth of tumor invasion and with the sequence of tumor in lower 1/3 region,middle 1/3 region to upper 1/3 region. Conclusions Sentinel lymph node mapping with methylene blue dye staining in gastric cancer is feasible and reliable.To patients with early stage of gastric cancer,SLN detection has a higher sensitivity and accuracy.And in lower 1/3 region and middle 1/3 region there are higher sensitivity and accuracy than in upper 1/3 region.

关 键 词：胃肿瘤 前哨淋巴结活组织检查 淋巴转移 肿瘤侵润 

分 类 号：R735.2[医药卫生—肿瘤]