术中前哨淋巴结测图在非小细胞肺癌中的应用

Intraoperative sentinel lymph node mapping for non-small cell lung cancer

目的探讨美蓝染色法前哨淋巴结测图技术在非小细胞肺癌手术中应用的可行性和对术后病理分期的影响。方法选取60例手术治疗的非小细胞肺癌患者,术中在肿瘤周围注射美蓝并寻找前哨淋巴结,检验前哨淋巴结检出率,并对常规病理检查阴性的前哨淋巴结行连续切片及免疫组化检测微转移。结果60例患者中共有55例(92%)检测到前哨淋巴结,其中22例患者前哨淋巴结及其他淋巴结未发现转移,有4例前哨淋巴结发现有微转移存在。结论美蓝染色法前哨淋巴结测图技术在非小细胞肺癌手术中的应用是可行的,此技术可以提高术后病理分期的准确性。

Objective To investigate the feasibility of the sentinel lymph node mapping with methylene blue in non-small cell lung cancer and its effect on pathologic staging. Methods This study was carried out on 60 patients with non-small cell lung cancer undergoing lung resection. Peritumoral tissue was infiltrated with methylene blue dye and The sentinel node was identified. Serial section histology and immunohistochemistry were used to validate the negative SN by conventional histopathologic evaluation and to identify the presence of mieromerastatie disease. Results Fifty-five patients had sentinel lymph nodes. In 22 cases neither The sentinel node nor any o,her lymph node contained metastatie carcinoma. In 4 patients, the sentinel node was found to harbor micrometastatic disease. Conclusions Intraoperative sentinel lymph node mapping with methylene blue in non-small cell lung cancer is feasible. This method can improve the precision of pathologic staging.