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进展期胃癌根治术中淋巴结示踪新方法
作者姓名:Jiang HW  Jian X  Xiao SM  Chen J  Tao Y
作者单位:621000,四川绵阳,川北医学院附属第二医院普外二科
摘    要:目的 探索进展期胃癌(AGC)淋巴结示踪方法。方法 胃角部AGC有第3组淋巴结(No.3)转移的根治术中,向No.3转移结节内或结节周边注射染料,切取近转移结节的二级前淋巴结(SSLN)活检。常规HE染色及免疫组化检查。结果 46例胃角部AGC中,找到SSLN38例,检出率82.6%(38/46),病理及免疫组化检查SSLN有转移30例,阳性率78.9%(30/38),找到SSLN68枚,有转移52枚,SSLN阳性率76.4%(52/68)。SSLN分布为:第7、5、4、6、9、8组SSLN枚数依次为40、9、7、5、4、3枚,病理及免疫组化检查阳性个数及阳性率分别是31(77.5%)、9(100%)、5(71.4%)、4(80.O%)、2(50.0%)、1(33.3%)。肿瘤大小、分化程度与SSLN的阳性发现无统计学意义。结论SSLN示踪技术拓展了SLN示踪技术的应用范围,为不同病期的胃癌淋巴结研究提供一种新思路;SSLN示踪技术对指导AGC合理科学及个体化淋巴结清扫提供了重要的参考依据。

关 键 词:胃肿瘤  淋巴结
修稿时间:2006-04-27

New method of lymph node tracing in gastrectomy for advanced gastric carcinoma
Jiang HW,Jian X,Xiao SM,Chen J,Tao Y.New method of lymph node tracing in gastrectomy for advanced gastric carcinoma[J].National Medical Journal of China,2007,87(4):268-270.
Authors:Jiang Huai-wu  Jian Xun  Xiao Shi-ming  Chen Jin  Tao Ya
Institution:Department of Surgery, The second Affilicated Hospital of North Sichuan Medical College, Mianyang 621000, China
Abstract:OBJECTIVE: To develop a new method of lymph node tracing in gastrectomy for advanced gastric carcinoma (AGC). METHODS: Forty-six patients with gastric angle carcinoma with metastasis in the third group lymph nodes underwent radical operation. During the operation methylene blue was injected inside or around the border of the metastatic third group lymph nodes. The secondary sentinel lymph nodes (SSLNs) that were the nearest to the third group lymph nodes were searched in 5 approximately 10 minutes, and the SSLNs discovered were resected to undergo HE staining and immunohistochemistry. RESULTS: SSLNs were found in 38 patients with a positive rate of 82.6% by methylene blue staining. Pathological examination found SSLNs in 30 cases with a positive rate of 78.9%. Totally 68 SSLNs were found in the 38 patients. The numbers of methylene blue positive SSLN in the groups 7, 5, 4, 6, 9, and 8 were 40, 9, 7, 5, 4, and 3 respectively. Pathology and histochemistry found 31, 9, 5, 4, 2, and 1 SSLNs in the groups 7, 5, 4, 6, 9, and 8 with the positive rates of 77.5%, 100%, 71.4%, 80.0%, 50.0%, and 33.3% respectively. There were no significant correlation between the size and degree of differentiation of tumor and the positive rate of SSLN. CONCLUSION: The technique of SSLN tracing expands the application range of SLN tracing and provides a new thinking for study of lymph node in gastric carcinoma in different stages.
Keywords:Stomach neoplasms  Lymph node
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