前哨淋巴结活检在早期胃癌中的应用及微转移检测

Clinical application of sentinel lymph node technology in early gastric carcinoma and micrometastasis detection

目的:探讨前哨淋巴结活检(SLNB)技术在早期胃癌中的应用及前哨淋巴结(SLN)微转移检测的临床意义。方法:34例早期胃癌术中亚甲蓝定位活检前哨淋巴结,术后行常规HE病理和角蛋白单克隆抗体AE1/AE3免疫组化(ELIVISION二步法)检查。结果:34例中33例检出SLN,检出率为97.1%。由SLN状态预测胃周淋巴结转移情况的准确率为93.9%(31/33),敏感性为88.9%(16/18),特异性为100.0%(16/16),假阴性率为11.1%(2/18)。免疫组化法与常规HE法对SLN转移的检出率相比较,差异有统计学意义(P=0.034),免疫组化法共检出12枚/8例SLN存在微转移现象。结论:SLN能较准确反映早期胃癌的淋巴结转移状况,免疫组化法较常规HE病理检查更为敏感,AE1/AE3免疫组化法能提高SLN微转移的检测,对确定临床分期、诊疗及判断预后有积极临床意义。

Objective: To investigate the application of sentinel lymph node biopsy to early gastric carcinoma and clinical significance of sentinel lymph node micrometastasis detection.Methods: 34 patients with early gastric carcinoma intraoperatively underwent sentinel lymph node biopsy with methylene blue.All SLNs were studied with HE and keratin monoclonal antibody AE1/AE3 immunohistochemistry.Results: The stained SLNs could be identified in 33(97.1%) of 34 patients.The accuracy of the SLN status in diagnosis of th...