可切除胃癌的前哨淋巴结示踪研究

目的 探讨前哨淋巴结活检在胃癌中的临床价值.方法 回顾性分析2003年1月至2006年6月46例行D2根治术的胃癌患者进行亚甲蓝前哨淋巴结活检的临床资料.结果 38例成功识别前哨淋巴结.前哨淋巴结敏感性、假阴性、准确性、特异性、阴性预测值及阳性预测值分别为69%(18/26)、31%(8/26)、79%(30/38)、100%(12/12)、60%(12/20)、100%(12/12).pT1期、TNM Ⅰ期和肿瘤直径<4 cm的患者,敏感性、准确性和阴性预测值均高达100%.肿瘤部位和淋巴结转移程度影响活检成功率,而肿瘤浸润深度、临床分期、淋巴结转移程度影响活检的敏感性、准确性和阴性预测值.结论 亚甲蓝前哨淋巴结活检在胃癌中的应用是可行的,早期患者的敏感性、准确性和可靠性高.

Sentinel lymph node mapping in patients with resectable gastric cancer

Objective To investigate the clinical significance of lymphatic mapping and sentinel lymph nodes (SLNs) biopsy in the diagnosis and treatment of gastric cancer. Methods A retrospective analysis was carried out based on the data of 46 patients who had received D2 gastrectomy from January 2003 to June 2006. The SLNs stained by methylene blue were resected for biopsy. Results The success rate of SLNs biopsy was 83% (38/46). The sensitivity, false-negative rate, accuracy, specificity, negative predictive value and positive predic-tive value of SLNs were 69% (18/26), 31% (8/26), 79% (30/38), 100% (12/12), 60% (12/20) and 100% (12/12). The sensitivity, accuracy and negative predictive value were 100% in patients with tumor in pT1 stage or TNM I stage, or with the diameters of the tumors under 4 era. The tumor site, and the degree of lymph node metastasis affected the success rate of biopsy, and the invasion depth, clinical stage and the degree of lymph node metastasis affected the sensitivity, accuracy and negative predictive value of biopsy. Conclusions The application of sentinel lymph node biopsy using methylene blue in gastrie cancer is feasible. The sensitivity, accuracy and reliability are high in patients at early stage of gastric cancer.