胃癌前哨淋巴结术中标识

Intraoperative Identification of Sentinel Lymph Node in Patients with Gastric Cancer.

目的:了解前哨淋巴结亚甲蓝显影对胃癌淋巴结转移的诊断价值。方法:术中向肿瘤边缘的正常胃壁浆膜下肌层、粘膜下层注射亚甲蓝,观察淋巴结显影的情况;切取各站淋巴结行病理检查。结果:术中进行淋巴结标识72例,成功检测出前哨淋巴结68例。术中病理检查,33例有淋巴转移。结论:前哨淋巴结术中能准确预测胃癌淋巴结转移状况。在手术治疗淋巴结转移阴性的胃癌患者中,前哨淋巴结术中标识有望免除常规淋巴清扫。

Objective： To investigate the clinical sentinel lymph node about gastric metastasis to the value of intraoperative methylene blue lymphography of lymph nodes. Methods： Methylene blue was injected intraoperatively from subserous muscle to submucosa of the normal gastric wall adjacent to the neoplasm, then lymphadenography was made, and the nodes were resected for histopathological examination. Result： The intraoperative lymphography with methylene blue on the lymphatic matastasis was done in 72 patients.The sentinel lymph nodes were found in 68 cases. After histopathological examination we found that 33 cases had metastasized. Conclusion： This study confirmed that the procedure of lymphatic mapping and sentinel lymph node dye in the operation in the patients with gastric cancer is feasible. The histological characteristics of the sentinel lymph node accurately predict the status of the lymph metastasis. We believe that this technique may replace the lymph node dissection for gastric cancer patients without lymphatic metastasis.