胃癌前哨淋巴结导航手术的研究进展

Sentinel lymph node navigation surgery for gastric cancer:a review to progress

胃癌是我国最常见的恶性肿瘤之一,手术是主要的治疗方式。随着胃癌规范化手术的推进,在保证根治性前提下,保留功能成为胃癌外科的发展理念。淋巴结清扫范围若要实现个体化,精确判断胃周淋巴结转移是重要因素,并且关乎胃癌预后。前哨淋巴结被定义为原发肿瘤的第一站引流淋巴结,也被认为是最可能的发生转移的淋巴结。因此,前哨淋巴结导航手术(SNNS)是一种低侵袭性的手术,可以避免过度的淋巴结清扫,也有助于降低手术并发症。胃癌的SNNS的概念提出至今已有10年时间,国内外学者先后开展了多项SNNS的临床研究,这也使得前哨淋巴结成为胃癌外科的科研热点。相关研究支持SNNS的有效性,这也推动了胃癌SNNS的发展。本文将对相关研究进行综述,总结近年来的研究,并展望未来发展。

Gastric cancer is one of the main causes of the most common cancer-related deaths in China, and surgical treatment is one of the most important tailor therapies. As radical surgery of gastric cancer promoting, it requires less invasive operation to avoid unnecessary lymph node dissection for function-preserving. It＇s extremely important to predict lymph node metastasis accurately, because that lymph node metastasis is a key prognostic indicator for gastric cancer patients. Sentinel lymph node is defined as the first lymphatic form the primary tumor draining lymph nodes, and it is the most likely nodes to have metastasis from the tumor. Therefore, sentinel lymph node navigation surgery （SNNS） is a low-invasive surgery, which can not only avoid excessive dissection, but also help reduce surgical complications. Results of SNNS were greatly increasing during the past decade, which made the sentinel lymph node a hot spot for gastric cancer. However, the clinical application of sentinel lymph node biopsy was still to be determined for further research. Muti-centered, randomized clinical trials should be initiated to address this problems. Studies in recent years were summarized for possible clinical implications, and prospects were discussed for development.