胃癌前哨淋巴结研究进展

Sentinel lymph node in gastric cancer

前哨淋巴结是从原发肿瘤淋巴引流途中首先可能发生转移的部位。Cabana在阴茎癌中提出前哨淋巴结的概念后,前哨淋巴结活检技术不断在多种肿瘤中广泛应用。目前,该技术已成功用于黑色素瘤、乳腺癌等手术。但在胃癌中,由于胃淋巴引流复杂、存在跳跃转移以及假阴性率较高,前哨淋巴结活检技术应用于临床还为时过早,其可行性和适用性尚无定论。因此,前哨淋巴结活检技术应用于胃癌,还有许多问题需要回答。

Sentinel lymph nodes （SLNs） are the first possible site of metastasis along the route of lymphatic drainage from a primary tumor. Since the sentinel node concept was initially proposed in penile cancer by Cabanas, the technique SLN biopsy has been confirmed in several tumor. Now, it has been used in operation of melanoma and breast cancer successfully. It is premature if SLN biopsy be used in gastric cancer because of the complicated lymphatic streams from the stomach and the presence of frequent skip metastasis, and higher false negative rates in the identification of sentinel nodes. To date, the feasibility and reliability of the SLNs for gastric cancer have never been well established. To apply SLN biopsy in gastric cancer, there are several questions need to be answered.