结直肠癌术中异硫蓝染色定位前哨淋巴结的研究

Significance of sentinel lymph node mapping during operation and in colon and rectum carcinoma

目的探讨结、直肠癌术中异硫蓝染色定位前哨淋巴结的可行性及其临床意义。方法对44例结直肠癌患者术中肿瘤周围注射异硫蓝，定位前哨淋巴结，手术结束后，对前哨淋巴结和其他淋巴结行苏木素-伊红染色。结果术中44例患者共检出前哨淋巴结114个，每例患者的前哨淋巴结为1—5个，平均（2．6±2．1）个，44例患者非前哨淋巴结共检出792个，每例患者的非前哨淋巴结为9—35个，平均（18．0±8．7）个，44例患者中有28例（64％）有淋巴结转移，16例（36％）无淋巴结转移。28例有淋巴结转移患者中26例（93％）有前哨淋巴结转移，2例（7％）无前哨淋巴结转移。结论结直肠癌术中异硫蓝染色定位前哨淋巴结准确性较高，具有较强的临床实用价值。

Objective To study the feasibility of sentinel lymph node （SLN） mapping during operation and the clinical value of analyzing lymph node metastasis of colon cancer. Methods SLN was mapped during operation by isosulfan stain in 44 cases with colon cancer. All lymph nodes were checked by routine pathological technique, while SLNs were checked by serial sectioning pathologic technique and immunohistochemistry. Results Twenty-eight of 44 cases were showed SLN. A total of 114 SLNs was positively inspected in 44 cases. The SLNs count in each ease was 1-5, （2.6 ± 2.1 ） SLNs in average. Seven hundred and ninety-two non-SLNs were inspected in these 44 cases. The non-SLNs count in each case was 9-35 （18.0 ± 8.7 in average）. In these 44 cases, 28（64% ） had lymphatic metastasis and 16 （36%） didnI. Twenty-six cases of the 28 who had lymphatic metastasis were inspected metastasis of SLNs. Conclusion The SLN mapping during operation is feasible and helpful to the positive finding rate of the metastatic lymph node of colon cancer.