Zhu Zhi-Hua, Li Bao-Jiang, Zhang Shi-Yi, Rong Tie-Hua, Zeng Can-Guang, Yu Hui, Hu Yi, Zhang Xu, Fu Jian-Hua, Long Hao, Lin Peng, Wang Si-Yu, Wang Xin, Yang Ming-Tian, Huang Zhi-Fan
Department of Thoracic Surgery, Cancer Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, P.R.China.
Ai Zheng. 2005 Mar;24(3):341-4.
BACKGROUND & OBJECTIVE: The metastasis status of regional lymph node is an important prognostic factor of non-small cell lung cancer (NSCLC). Sentinel lymph node (SLN) mapping and biopsy is a quick and high efficient technique to intraoperatively detect occult micrometastatic disease, however, its application in NSCLC is immature. This study was designed to investigate the feasibility of detecting SLN in patients with NSCLC during radical surgery, and to evaluate its accuracy of predicting metastasis status of regional lymph node.
Fifty patients with NSCLC underwent SLN detection. During radical operation, 4 ml of 1% isosulfan blue was injected into the lung tissue around the tumor at 3, 6, 9, and 12 o'clock sites. Location and number of blue dyed SLNs were recorded, and compared with pathologic results to calculate the accuracy and false negative rate of SLN detection.
Blue dyed SLNs were seen in 33 patients with a detection rate of 66.0%. SLNs located in N1 lymph node of 24 patients (72.7%), in N2 lymph node of 6 patients (18.2%), in both N1 and N2 lymph nodes of 3 patients (9.1%). Approved by pathology, the accuracy of SLN detection was 87.9% (29/33), the sensibility was 73.3% (11/15), the false negative rate was 26.7% (4/15).
SLN detection is valuable for predicting hilar and mediastinal lymph nodes metastases in NSCLC.
区域淋巴结转移状态是非小细胞肺癌(NSCLC)重要的预后因素。前哨淋巴结(SLN)定位及活检是术中检测隐匿性微转移疾病的一种快速高效技术,然而,其在NSCLC中的应用尚不成熟。本研究旨在探讨在NSCLC患者根治性手术中检测SLN的可行性,并评估其预测区域淋巴结转移状态的准确性。
50例NSCLC患者接受SLN检测。在根治性手术中,于肿瘤周围肺组织的3、6、9和12点位注射4ml 1%异硫蓝。记录蓝色染色SLN的位置和数量,并与病理结果进行比较,计算SLN检测的准确性和假阴性率。
33例患者见蓝色染色SLN,检出率为66.0%。SLN位于N1淋巴结者24例(72.7%),位于N2淋巴结者6例(18.2%),位于N1和N2淋巴结者3例(9.1%)。经病理证实,SLN检测的准确性为87.9%(29/33),敏感性为73.3%(11/15),假阴性率为26.7%(4/15)。
SLN检测对预测NSCLC肺门及纵隔淋巴结转移具有重要价值。