前哨淋巴结活组织检查技术在胃癌根治术中的应用价值  

Clinical significance of sentinel lymph node biopsy for gastric cancer surgery

作　　者：王晓华[1] 沈洁[1] 陈建安[1] 张金成[1] 

机构地区：[1]南方医科大学附属小榄医院肿瘤外科,广东中山528415

出　　处：《广州医学院学报》2013年第4期59-61,共3页Academic Journal of Guangzhou Medical College

摘　　要：目的:探讨前哨淋巴结定位与活组织检查在胃癌根治术中的作用。方法:使用亚甲蓝对22例胃癌患者先行前哨淋巴结标识活组织检查,然后行标准胃癌根治术,术后行常规HE病理及免疫组化检查,通过前哨淋巴结计算胃癌淋巴结转移诊断的准确率、敏感性及假阴性率。结果:22例患者中21例成功检出前哨淋巴结,检出率为95.5%(21/22)。前哨淋巴结预测胃周淋巴结转移的准确率为95.2%(20/21),敏感性为94.1%(16/17),特异性为100%(21/21),假阴性率为5.9%(1/17)。结论:术中使用亚甲蓝染色定位胃癌前哨淋巴结安全可行,并能准确反映胃癌周围淋巴结的转移状态。可用于指导胃癌的淋巴结清扫范围。Objective： To investigate the role of sentinel lymph node biopsy （SLNB） for gastric cancer surgery. Methods： Twenty-two patients with gastric cancer underwent lymphatic mapping and SLNB by using methylene blue. This was followed by standardized radical resections of gastric cancer and hemotoxylin-eosin staining and immunohistochemistry assay to determine the diagnostic accuracy, sensitivity and false-negative rate. Results： Of the 22 cases recruited in the study, SLNs were identified successfully in 21 cases （95.5%）. SLN yielded an accuracy of 95.2% （20/21） , specificity of 100% （21/21） , sensitivity of 94.1% （16/17） and false negative rate of 5. 9% （ 1/17 ） for the diagnosis of the lymph node metastasis. Conclusion： Injection of methylene blue for locating the SLN is a feasible approach to accurately predict lymph node metastasis of gastric cancer and can be used to guide the scope of lymph node dissection.

关 键 词：胃癌 前哨淋巴结 亚甲蓝 

分 类 号：R735.2[医药卫生—肿瘤]