亚甲蓝示踪技术在胃癌前哨淋巴结中的应用价值  

Clinical Value of sentinel lymph node mapping by using methylene blue dye-only method in gastric cancer

作　　者：刘建明[1] 马利林[1] 尤建权 孙锦卫[3] 王伟[1] 朱建伟[1] 秦军[1] 

机构地区：[1]南通大学附属医院普外科,江苏226001 [2]泰州人民医院外科 [3]盐城市第三人民医院外科

出　　处：《交通医学》2012年第5期407-410,共4页Medical Journal of Communications

基　　金：江苏省南通市科技局资助项目(S2006021)

摘　　要：目的:探讨亚甲蓝示踪技术在胃癌前哨淋巴结(SLN)中的应用价值与临床意义。方法:胃癌60例患者,开腹术中于病灶周围浆膜下直接注入亚甲蓝,术后对被视为胃癌前哨淋巴结的蓝染的淋巴结行常规病理检查和免疫组织化学法检查。结果:胃癌60例中,检出SLN56例(93.3%)。HE检查发现24例49枚SLN转移,T1、T2期SLN示踪准确率93.9%,敏感性88.9%,假阴性率11.1%,特异性为100.0%。免疫组织化学法检查结果发现有32例67枚SLN转移。结论:亚甲蓝示踪技术在胃癌SLN的应用是安全可行的,对预测T1、T2期胃癌区域淋巴结状况具有重要参考价值。Objective：To investigate the clinical value of sentinel lymph node （SLN） mapping using methylene blue dye-only method in gastric cancer. Methods： Sixty patients of gastric cancer were enrolled in this study. Immediately after laparotomy ,methylene blue was injected into subserosal layer adjacent to the tumor. Those blue stained nodes defined as SLNs were then removed for routine HE stain and immunohistochemical （IHC） staining, respectively. Results：Of the 60 pa- tients,SLNs were detected in 56 （93.3%） and 49 SLNs were detected in 24 patients by HE staining.In eases of T1 and T2 gastric cancers, the accuracy of SLN mapping was 93.9%, the sensitivity was 88.9%, the false-negative rate was 11.1%, and the specificity was 100%. 67 SLNs were detected in 32 patients by immunohistochimical staining. Conclusions： Our results suggest that SLN mapping with methylene blue dye alone represents a safe procedure that seems to be adaptable for those patients undergoing open surgery for gastric cancer .The procedure has high sensitivity and specificity, especially in cases of T1 and T2 tumors.

关 键 词：胃癌 前哨淋巴结 亚甲蓝染色法 免疫组织化学法 敏感性 特异性 

分 类 号：R735.2[医药卫生—肿瘤]