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目的探讨在非小细胞肺癌(NSCLC)中前哨淋巴结(SLN)转移与临床病理因素的关系。方法对40例NSCLC患者于术中在肿瘤边缘分四个象限注入亚甲蓝4ml标识并切除SLN,行连续切片中的病理诊断和广谱细胞角蛋白免疫组化检测;同时按标准肺癌根治术清扫淋巴结,所取淋巴结送HE染色及免疫组化检查。结果40例NSCLC患者中,由SLN检测转移的灵敏度为91.3%,准确率为94.3%,假阴性率为8.7%;46枚SLN中39枚分布于N1淋巴结,7枚分布于N2淋巴结,其中以叶间淋巴结检出率最高;SLN阳性率与肿瘤的大小、P-TNM临床分期、SLN大小呈明显的相关性。结论SLN能较为准确的反映NSCLC区域淋巴结的转移情况,为手术中淋巴结的清扫范围提供依据。
Objective To investigate the relationship between SLN metastasis and clinicopathologic factors in non-small cell lung cancer (NSCLC). Methods 40 cases of NSCLC patients were injected with 4ml methylene blue 4ml in the margins of the tumor during operation to remove the SLN. The pathological diagnosis and broad-spectrum cytokeratin immunohistochemistry were performed in serial sections. At the same time, Lymph node dissection, lymph nodes were taken to HE staining and immunohistochemistry. Results The sensitivity and specificity of SLN in 40 patients with NSCLC were 91.3%, 94.3% and 8.7%, respectively. 39 of 46 SLNs were located in N1 lymph nodes and 7 in N2 lymph nodes. Among them, The positive rate of SLN was significantly correlated with tumor size, P-TNM clinical stage and SLN size. Conclusion SLN can reflect the metastasis of lymph nodes in NSCLC more accurately and provide the basis for the dissection of lymph nodes in operation.