前哨淋巴结定位检测在早期诊断进展期胃癌中的作用分析

Effects analysis of detection of sentinel lymph node for the early diagnosis of advanced gastric

目的:研究前哨淋巴结定位检测在早期诊断进展期胃癌中的作用。方法:选择本院接诊的100例进展期胃癌患者进行研究。使用亚甲蓝对前哨淋巴结(SLN)进行定位,再取活检,在术后行常规的HE病理活检。结果:100例进展期胃癌患者中,SLN检出患者98例,检出率98.00%。98例SLN患者中,SLN对于胃癌预测的敏感性为90.74%(49/54),总的准确率为94.90%(93/98),总特异性为100.00%(44/44),总假阴性率为9.26%(5/54);随胃癌浸润深度的逐步增加,SLN用来预测胃癌的敏感性及准确率逐步降低,假阴性率逐步增高,差异均具有统计学意义(P<0.05);从L区、M区到U区,SLN用来预测胃癌的敏感性及准确率逐步升高,假阴性率逐步降低,差异均具有统计学意义(P<0.05)。结论:前哨淋巴结定位检测对于早期诊断进展期胃癌的敏感性准确率都很高,特别是对于早期胃癌的筛查具有重要价值,值得临床推广。

Objective： To study the effects of detection of sentinel lymph node for the early diagnosis of advanced gas trio. Methods： 100 patients of advanced gastric cancer treated in our hospital were studied. Methylene blue was applied to locate the sentinel lymph node （SLN） for a biopsy in order to check conventional HE biopsy after Undergoing the surgery. Results： According to SLN results, 100 cases of advanced gastric cancer were detected with an accuracy of 98.00%. In 98 cases, sensitivity rate of SLN for predicting gastric was 90.74% （49/54）, the overall accuracy rate was 94.90% （93/98）, specificity rate was 100.0% （44/44）, total false negative rate was 9.26~/00 （5/54）. With the gradual increase in the depth of invasion, sensi- tivity rate of SLN being used to predict the gastric cancer was gradually reduced （P〈0.05） ; accurate rate of SLN being used to predict the gastric cancer was gradually reduced （P〈0.05） ; false-negative rate of SLN used to predict the gastric cancer was gradually increased （P〈0.05）. From L area, M area to the U District, the sensitivity of SLN used to predict gastric cancer was gradually increased （P〈0.05）; accurate rate of SLN for predicting gastric cancer was gradually increased （P〈0.05）; false negative rate of SLN used to predict gastric cancer was gradually reduced （P〈0.05）. Conclusion： Detection of sentinellymph node has a good effect for the early diagnosis of advanced gastric; it has high accuracy rate and sensitivity. It shows important value for screening of early gastric cancer. It is worthy of promotion in clinic.