胃癌前哨淋巴结定位及活检技术探讨

Discussion of the Location of Sentinel Lymph Nodes in Gastric Cancer and Its Biopsy Technique

目的:研究并探讨对胃癌患者进行前哨淋巴结定位及活检的可行性和临床价值。方法:选取2011年1月-2015年1月笔者所在医院进行胃癌根治手术的100例患者作为研究对象,在手术过程中,使用亚甲蓝前哨淋巴结进行定位活检,对其定位活检结果进行分析,并与术后病理诊断结果进行对比。结果:100例患者中被检出前哨淋巴结转移84例,检出率为84%。术后病理诊断结果显示,100例患者中早期胃癌34例,中晚期胃癌66例;而84例被检出前哨淋巴结转移患者中,早期胃癌32例,中晚期胃癌52例。早期胃癌定位活检的敏感度为94.12%,中晚期胃癌定位活检的敏感度为78.79%,定位活检对早期胃癌的敏感度较中晚期胃癌明显更高,差异有统计学意义(P<0.05)。结论:对胃癌患者进行前哨淋巴结定位活检,具有较高的检出率,且其诊断早期胃癌的准确性高于中晚期胃癌。

Objective：To study and explore the feasibility and clinical value of the localization and biopsy of the sentinel lymph nodes in patients with gastric cancer.Method：100 cases of gastric cancer patients in our hospital were selected from January 2011 to January 2015 as the research object. During the operation,the sentinel lymph nodes of patients were analyzed by using methylene blue,and compared the results with the pathological diagnosis.Result：84 cases of the 100 patients were detected with sentinel lymph node metastasis,the detection rate was 84%.The postoperative pathological diagnosis showed that there were 34 patients had early gastric cancer,and 66 patients had advanced gastric cancer of the 100 patients;Of the 84 patients with sentinel lymph node metastasis,32 patients had early gastric cancer,and 52 patients had middle and late gastric cancer.The sensitivity of early gastric biopsy was 94.12%,and the sensitivity of biopsy was 78.79%,and the sensitivity of early gastric cancer was significantly higher than that in advanced gastric cancer（P〈0.05）.Conclusion：The sentinel lymph node biopsy in gastric cancer patients with high detection rate,and the accuracy of the diagnosis of early gastric cancer is higher than that of the middle and late stage.