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
海蓝组织细胞增生症(sea-blue histiocytosis)或海蓝组织细胞综合症(syndrome of the sea-blue histiocyte)是一种脂质蓄积性疾病,1954年由Sawitsky首次报道.其特点是患者骨髓、脾、肝、肺等组织器官被一种特殊的细胞浸润,这种细胞在Wri...海蓝组织细胞增生症(sea-blue histiocytosis)或海蓝组织细胞综合症(syndrome of the sea-blue histiocyte)是一种脂质蓄积性疾病,1954年由Sawitsky首次报道.其特点是患者骨髓、脾、肝、肺等组织器官被一种特殊的细胞浸润,这种细胞在Wright染色时,胞浆内有大量海蓝色颗粒.鉴于本病的诊断和鉴别诊断比较困难,而且过去一直认为是罕见病,没有引起人们的足够重视,但是自从1980年国内首次报道以来。展开更多
文摘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.
文摘海蓝组织细胞增生症(sea-blue histiocytosis)或海蓝组织细胞综合症(syndrome of the sea-blue histiocyte)是一种脂质蓄积性疾病,1954年由Sawitsky首次报道.其特点是患者骨髓、脾、肝、肺等组织器官被一种特殊的细胞浸润,这种细胞在Wright染色时,胞浆内有大量海蓝色颗粒.鉴于本病的诊断和鉴别诊断比较困难,而且过去一直认为是罕见病,没有引起人们的足够重视,但是自从1980年国内首次报道以来。
