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
刘建明;马利林;尤建权;孙锦卫;王伟;朱建伟;秦军;
摘要(Abstract)：
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。
关键词(KeyWords)： 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
基金项目(Foundation): 江苏省南通市科技局资助项目(S2006021)
作者(Authors): 刘建明;马利林;尤建权;孙锦卫;王伟;朱建伟;秦军;
参考文献(References)：
- [1]Songun I,Putter H,Kranenbarg EM,et al.Surgical treatmentof gastric cancer:15-year follow-up results of the ran-domised nationwide Dutch D1D2 trial[J].Lancet Oncol,2010,11(5):439-449.
- [2]Cardoso DM,Campoli PM,Yokoi C,et al.Initial experiencein Brazil with endoscopic submucosal dissection for earlygastric cancer using insulation-tipped knife:a safety andfeasiblity study[J].Gatric Cancer,2008,11(4):226-232.
- [3]Nieweg OE,Bartelink H.Implications of lymphatic mappingfor staging and adjuvant treatment of patients with breastcancer[J].Eur J Cancer,2004,40(2):179-181.
- [4]Kretschmer L,Hilgers R,Mohrle M,et al.Patients withlymphatic metastasis of cutaneous malignant melanoma bene-fit from sentinel lymphnodectomy and early excision of theirnodal disease[J].Eur J Cancer,2004,40(2):212-218.
- [5]Yanagita S,Natsugoe S,Uenosono Y,et al.Sentinel node mi-crometastases have high proliferative potential in gastric can-cer[J].J Surg Res,2008,145(2):238-243.
- [6]刘宏斌,韩晓鹏,孟文结,等.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):81-84.
- [7]Lee JH,Ryu KW,Kim CG,et al.Comparative study of thesubserosal versus submucosal dye injection method for sen-tinel node biopsy in gastric cancer[J].Eur J Surg Oncol,2005,31(9):965-968.
- [8]Lee SE,Lee JH,Ryu KW,et al.Sentinel node mapping andskip metastases in patients with early gastric cancer[J].AnnSurg Oncol,2009,16(3):603-608.
- [9]Bravo Neto GP,Santos EG,Loja CA,et al.Minor gastric re-sections with modified lymphadenectomy in early gastriccancer with negative sentinel node[J].Rev Col Bras Cir,2012,39(3):183-188.
- [10]Miyashiro I.What is the problem in clinical application ofsentinel node concept to gastric cancer surgery[J]?J GastricCancer,2012,12(1):7-12.