胃癌前哨淋巴结体外检测的临床意义

Clinical significance of ex vivo detection of sentinel lymph node in gastric cancer

AIM: To investigate the feasibility of ex vivo sentinel lymph node (SLN) mapping and its clinical significance in improving the staging of gastric cancer. METHODS: Nineteen patients received curative resection of primary gastric cancer with extended lymph node dissection were included in this study. Gastric specimens were submucosally or subserosally injected with 10 g/L Patent Blue. The blue-stained SLNs were excised for routine pathological examination (hematoxylin and eosin staining). The SLNs, which were negative after HE staining, were further examined by cytokeratin immunohistochemistry. RESULTS: The SLNs were identified in 89.5%(17/19) cases, with a mean number of 1.4 (1-3) for each case. After HE staining, the accuracy of the SLNs in diagnosis of the regional lymph node metastasis was 70.5% (12/17), and the false-negative rate was 38.4%. However, one case (25%) was upstaged by cytokeratin immunohistochemistry. Thus, the diagnostic accuracy increased to 88.2% and the false-negative rate decreased to 14.2%. CONCLUSION: Ex vivo SLN mapping in gastric canceris technically feasible and may upstage some of the gastric cancer.