胃癌前哨淋巴结临床意义的研究
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刘宏斌

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Study on the clinical significance of sentinel nodes in gastric cancer
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    摘要:

    目的:观察胃癌前哨淋巴结的分布,探讨其临床意义。方法:回顾性分析288例胃癌前哨淋巴结术中染色后显影的范围及特征。术中向肿瘤边缘的正常胃壁浆膜下肌层、黏膜下层注射亚甲蓝,观察淋巴结显影的情况;切取各站淋巴结行病理检查。结果:288例胃癌术后病理诊断为T1期102例,T2期126例,T3期60例。术中成功显影270例,阳性率为93.8%。102例患者有淋巴结转移,其中前哨淋巴结(SNs)与非前哨淋巴结(non-SNs)均有转移者66例,仅前哨淋巴结有转移者18例,仅非前哨淋巴结有转移者18例。结论:通过前哨淋巴结,术中能准确预测胃癌淋巴结转移状况。在手术治疗淋巴结转移阴性的胃癌患者中,前哨淋巴结术中标识有望免除常规淋巴清扫。

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    Abstract:Objective:To observe the distribution of sentinel nodes(SN) in gastric cancer, and investigate their clinical significance. Methods:The extent and features of intraoperatively stained sentinel nodes in 288 cases of gastric cancer were analyzed retrospectively. Methylene blue was injected intraoperatively into the subseral muscle and submucosa of the normal gastric wall adjacent to the neoplasms,then lymphadenography was performed,and the nodes were resected for histopathological examination. Results:The pathological diagnosis of the 288 cases with gastric cancer was T1 in 102 cases,T2 106 cases and T3 60 cases. Stained nodes were detectable in 270 cases(success rate: 93.8%). One hundred and two cases were found to have lymph node metastasis; 66 cases had metastasis in both SNs and non-SNs; 18 cases in SNs alone; and 18 cases in non-SNs alone. Conclusions:Sentinel lymph nodes can accurately predict the lymph node metastatic status of gastric cancer patients during operation. Intraoperative sentinal lymph node mapping can avoid routine lymph node dissection in patients with gastric cancer with negative lymph node metastasis.

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刘宏斌,韩晓鹏,孟文喆,孙鑫,苏琳.胃癌前哨淋巴结临床意义的研究[J].中国普通外科杂志,2006,15(2):1-84.
DOI:10.7659/j. issn.1005-6947.2006.02.001

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  • 在线发布日期: 2006-02-25