Shimazui Toru, Kawai Koji, Akaza Hideyuki
Dept of Urology, Institute of Clinical Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan.
Gan To Kagaku Ryoho. 2004 Nov;31(12):2073-5.
It is generally accepted that renal cell carcinoma (RCC) usually metastasizes to distant organs through blood circulation rather than lymphatogeneous dissemination. Clinical and autopsy studies have revealed that most lymph node (LN) metastases accompany distant metastasis. In addition, LN dissection (LND) can reveal a positive node in limited cases in which nodes negative preoperatively, suggesting that diagnostic significance of LND is low in such cases. Although the significance of LND in RCC remains controversial, it is also reported that RCC patients with regional LN metastasis alone had an improved survival after LND. Animal models have indicated that detection of sentinel nodes in RCC might facilitate a more personalized treatment of LND in RCC.
一般认为，肾细胞癌（RCC）通常通过血液循环转移至远处器官，而非通过淋巴系统扩散。临床和尸检研究表明，大多数淋巴结（LN）转移伴随远处转移。此外，淋巴结清扫术（LND）在少数术前淋巴结阴性的病例中可发现阳性淋巴结，这表明LND在这些病例中的诊断意义较低。尽管LND在RCC中的意义仍存在争议，但也有报道称，仅发生区域LN转移的RCC患者在接受LND后生存率有所提高。动物模型表明，检测RCC中的前哨淋巴结可能有助于对RCC进行更个性化的LND治疗。
