早期胃癌前哨淋巴结的分布及其临床意义

Distribution and clinical significance of sentinel lymph node in early gastric cancer

目的:研究早期胃癌前哨淋巴结(Sentinellymphnode,SLN)的分布规律并探讨其在早期胃癌手术治疗中的临床应用价值。方法:将只有1个转移的淋巴结视为SLN,回顾性分析只有SLN的34例早期胃癌的临床资料,总结早期胃癌SLN的出现部位与原发病灶的关系。结果:在6例胃上1/3(U)癌中单个转移淋巴结均分布在N1,而且都在邻近原发癌灶周围(No.1,2,3);4例中1/3(M)癌也都分布在N1,其中3例在邻近原发癌灶周围(No.3,4),1例在原发病灶相对较远处(No.1);24例胃下1/3(L)癌中,23例分布在N1,其中17例在邻近原发癌灶周围,6例在原发病灶相对较远处(No3,4),1例发生“跳跃性转移”(N2),分布在肝总动脉旁(No.8)。97.1%早期胃癌前哨淋巴结分布在N1,76.5%(26/34)发生在原发病灶邻近处(N1),20.6%(7/34)发生在原发病灶相对较远处(N1),而只有2.9%(1/34)出现跳跃性转移(N2)。结论:早期胃癌SLN的分布符合淋巴结转移规律,其检测为进一步行前瞻性研究提供了理论依据,也为早期胃癌制定合理的手术方案提供了依据。

Objective： To study the distribution of sentinel lymph node（SLN） and discuss the clinical applied value in early gastric cancer. Methods： The location of sentinel lymph node was examined and correlation with the site of primary tumor was studied retrospectively in 34 early gastric cancer patients. Results： In six cases of Up gastric cancer, The SLN were detected in the nearest of perigastric nodal area （No.1,2,3）;In four cases of Middle gastric cancer, three cases were detected in the nearest of perigastric nodal area（No.3,4）,one case were detected in a fairly remote perigastric area （No.1）; In twenty-four cases of Low gastric cancer, seventeen cases were detected in N1, six cases were detected in a fairly remote perigastric area, SLN of one case was leaping metastasis（N2）, it was No.8, After all, the SLN were detected in the nearest of perigastric nodal area in 76.5% of cases,in a fairly remote perigastric area in 20.6% of them, and in N2 area without N1 involvement in 2.9% of cases （N2）.Conclusions： The location of SLN in early gastric cancer is accord with the rule of lymph nodes metastasis,it provided the theory bases to further prospective study SLN in early gastric cancer and to establish reasonable approach in the treatment of early gastric cancer.