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目的:探讨肿瘤前哨淋巴结(SLN)活检在胃癌术中应用的可行性。方法:将32例胃癌患者按肿瘤浸润深度分组,用术中注射专利蓝的方法定位前哨淋巴结,以细胞角蛋白(CK)免疫组织化学染色判断淋巴结转移情况。结果:32例患者全部检出SLN(100%)。出现淋巴结转移的有22例,其中SLN出现转移的有20例。SLN预测淋巴结癌转移的敏感性、假阴性率和准确率分别20/22(91%)、2/22(9%)和30/32(93.8%);胃癌T1组无SLN假阴性者,准确率6/6(100%);T2组无SLN假阴性者,准确率12/12(100%);T3组假阴性1例,准确率9/10(90%);T4组假阴性1例,准确率3/4(75%)。结论:采用肿瘤周围注射专利蓝的方法术中定位淋巴结是可行的SLN术中定位方法。
Objective: To investigate the feasibility of using SLN biopsy in the operation of gastric cancer. Methods: Thirty-two patients with gastric cancer were divided into groups according to the depth of tumor infiltration. Sentinel lymph nodes were located by intraoperative injection of patent blue and the lymph node metastasis was determined by cytokeratin (CK) immunohistochemical staining. Results: All 32 patients were detected with SLN (100%). There were 22 cases of lymph node metastasis, of which 20 cases of SLN metastasis. The sensitivity, false negative rate and accuracy of SLN in predicting lymph node metastasis were 20/22 (91%), 2/22 (9%) and 30/32 (93.8%) respectively. The rate of false negative in T3 group was 1 case (9%, 90%), and the false negative rate in T4 group was 1 case , Accuracy rate of 3/4 (75%). CONCLUSION: Intraoperative localization of lymph nodes using the patent blue injection of tumor around the tumor is feasible SLN intraoperative localization method.