结肠癌术中前哨淋巴结定位对临床治疗的指导意义

目的:评价前哨淋巴结(SLN)对结肠癌腹腔淋巴结转移状况的预测价值,探讨检测SLN在指导结肠癌根治性切除术中的意义.方法:对42例结肠癌患者利用亚甲蓝行SLN检测术,并切除SLN送快速冰冻病理检查,然后行结肠癌根治性切除术,比较SLN快速冰冻切片,SLN及其他腹腔淋巴结石蜡切片和抗角蛋白免疫组织化学染色结果.结果:42例患者中39例成功检测到SLN,共检出SLN 95枚,平均2.4枚,SLN检出率为92.9%(39/42).SLN活组织检查术灵敏度为75%,准确性为85.7%,SLN预测腹腔淋巴结状态与术后病理检查符合率为92.3%.结论:SLN检测能较为准确地预测结肠癌腹腔淋巴结的转移状况,但以SLN活检术替代传统术式的可行性和安全性还需要更大样本的前瞻性病例研究来进一步评价.

Clinical Significance of Sentinel Lymph Nodes Mapping in Colon Carcinoma Operations

Objective: To study the value of sentinel lymph nodes(SLN)to predict the celiac lymph nodes status and approach the significance of SLN detection in radical operation with colon carcinoma. Methods: 42 patients with colon carcinoma planned to undergo radical operation received an injection of blue dye to identify and remove SLNs. The SLNs were compared with non-SLNs with frozen slide,final histopathological and anti-CK immunohistochemical results. Results: SLNs were found in 39 patients, 95 SLNs were identified, the mean number was 2.4. The detection rate of SLN was 92.9%. Sensitivity, specificity and accuracy of the SLN biopsy were 75%, 85.7% and 92.3%, respectively. Conclusion: SLNs detection can precisely predict the celiac lymph nodes status in colon cancer,but the feasibility and security of this technique substituting conventional surgical modality should be evaluated by large series of prospective case studies.