Objective： The aim of this study was to explore a new method of lymph node tracing in radical gastrectomy for advanced gastric carcinoma （AGC）. Methods： Ninety-two patients who suffered from gastric angle carcinom...Objective： The aim of this study was to explore a new method of lymph node tracing in radical gastrectomy for advanced gastric carcinoma （AGC）. Methods： Ninety-two patients who suffered from gastric angle carcinoma with metastasis in No. 3 group lymph nodes were carried out radical gastrectomy. During the operation methylene blue was injected inside or around the circum of the metastatic No. 3 group lymph nodes. Secondary sentinel lymph nodes （SSLNs） were the near- est blue lymph nodes to No. 3 group lymph nodes that were searched in 5 to 10 rain after injecting methylene blue. These SSLNs were resected and carried out hematoxylin-eosin （HE） staining as well as immunohistochemistry （IHC） staining to demonstrate whether there were metastasis. Results： SSLNs were found successfully in 76 patients with a positive rate of 82.6% （76/92） by methylene blue staining, among which, 34 patients were demonstrated existing metastasis in SSLNs by HE staining, 26 patients were demonstrated existing metastasis in SSLNs by IHC staining which were not demonstrated exist- ing metastasis by HE staining. Totally, 60 patients were demonstrated existing metastasis in SSLNs by HE staining and IHC staining with a positive rate of 78.9% （60/76）. 136 SSLNs were found in total and 104 SSLNs were demonstrated existing metastasis with a positive rate of 76.4% （104/136）. There were 14, 18, 10, 80, 6 and 8 SSLNs in No. 4, No. 5, No. 6, No. 7, No. 8 and No. 9 group lymph nodes respectively. And there were 10, 18, 8, 62, 2 and 4 SSLNs were demonstrated existing metastasis with a positive rate of 71.4%, 100%, 80.0%, 77.5%, 33.3% and 50.0% in No. 4, No~ 5, No. 6, No. 7, No. 8 and No. 9 group lymph nodes respectively. However, there were no significant correlations between the tumor＇s size and the positive rate of SSLN as well as the degree of tumor＇s differentiation and the positive rate of SSLN. Conclusion： The technique of SSLN tracing expands the application range of sentinel lymph node （SLN） tracing and provides a new thinking for researching of SLN in AGC.展开更多
基金Supported by a grant from the Scientific Research Project of Sichuan Provincial Health Department (No. 050182)
文摘Objective： The aim of this study was to explore a new method of lymph node tracing in radical gastrectomy for advanced gastric carcinoma （AGC）. Methods： Ninety-two patients who suffered from gastric angle carcinoma with metastasis in No. 3 group lymph nodes were carried out radical gastrectomy. During the operation methylene blue was injected inside or around the circum of the metastatic No. 3 group lymph nodes. Secondary sentinel lymph nodes （SSLNs） were the near- est blue lymph nodes to No. 3 group lymph nodes that were searched in 5 to 10 rain after injecting methylene blue. These SSLNs were resected and carried out hematoxylin-eosin （HE） staining as well as immunohistochemistry （IHC） staining to demonstrate whether there were metastasis. Results： SSLNs were found successfully in 76 patients with a positive rate of 82.6% （76/92） by methylene blue staining, among which, 34 patients were demonstrated existing metastasis in SSLNs by HE staining, 26 patients were demonstrated existing metastasis in SSLNs by IHC staining which were not demonstrated exist- ing metastasis by HE staining. Totally, 60 patients were demonstrated existing metastasis in SSLNs by HE staining and IHC staining with a positive rate of 78.9% （60/76）. 136 SSLNs were found in total and 104 SSLNs were demonstrated existing metastasis with a positive rate of 76.4% （104/136）. There were 14, 18, 10, 80, 6 and 8 SSLNs in No. 4, No. 5, No. 6, No. 7, No. 8 and No. 9 group lymph nodes respectively. And there were 10, 18, 8, 62, 2 and 4 SSLNs were demonstrated existing metastasis with a positive rate of 71.4%, 100%, 80.0%, 77.5%, 33.3% and 50.0% in No. 4, No~ 5, No. 6, No. 7, No. 8 and No. 9 group lymph nodes respectively. However, there were no significant correlations between the tumor＇s size and the positive rate of SSLN as well as the degree of tumor＇s differentiation and the positive rate of SSLN. Conclusion： The technique of SSLN tracing expands the application range of sentinel lymph node （SLN） tracing and provides a new thinking for researching of SLN in AGC.
