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应用前哨淋巴结对结肠癌分期:放射性胶体和蓝色染料前哨淋巴结活检标本的价值
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作者 Terwisscha Van Scheltinga S.E.J. den boer f.c. +2 位作者 Pijpers R. J.R.M. Van Der Sijp 张红凯 《世界核心医学期刊文摘(胃肠病学分册)》 2006年第11期55-55,共1页
Background. Nodal staging accuracy is important in the prognosis and selection of patients for chemotherapy. This prospective study aims to assess the feasibility and accuracy of the sentinel lymph node procedure (SNP... Background. Nodal staging accuracy is important in the prognosis and selection of patients for chemotherapy. This prospective study aims to assess the feasibility and accuracy of the sentinel lymph node procedure (SNP) using radiocolloid and blue dye in colon carcinoma. Methods. In 56 patients, lymphatic mapping was accomplished by means of intraoperatively injecting patent blue and nanocoll subserosally around the tumour. Sentinel nodes (SNs) were harvested ex-vivo . Nodes were stained with H&E. If lymph nodes were interpreted as negative for metastatic tumour, serial sectioning and immunohistochemical staining were performed. Results. At least one SN was detected in 49 of 53 patients (92.5%). Three patients were excluded because of preoperatively detected metastases. Overall, 121 SN were harvested with a mean of 2.2 SN/patients. Eighteen patients had tumour positive nodes. In four patients, pathological nodes were palpable during operation and were excluded. The SN was histologically negative in 2 of 14 patients with positive nodes (false-negative rate 14.3%). In 5 of 14 patients with positive nodes, the SN was the exclusive site of regional nodal metastasis. Four patients were upstaged by immunohistochemical staining (28.6%). The negative predictive value was 93.9%and the overall accuracy 95.6%. Scintigraphy was done in 17 patients. In three patients the SN was detected only by this modality. Discussion. The SN biopsy with the combined technique proved a feasible technique with a steep learning curve. It can change the initial staging from stage Ⅱ to stage Ⅲ colon carcinoma. Scintigraphy can improve the success rate of the technique. 展开更多
关键词 前哨淋巴结 放射性胶体 结肠癌 蓝色染料 组织学检查 假阴性率 局部淋巴结转移 免疫组化染色 细胞转
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