Moenig S P, Luebke T, Baldus S E, Schroeder W, Bollschweiler E, Schneider P M, Hoelscher A H
Department of Visceral and Vascular Surgery, University of Cologne, Joseph-Stelzmann-Strasse 9, 50924 Cologne, Germany.
Anticancer Res. 2005 Mar-Apr;25(2B):1349-52.
The feasibility and diagnostic reliability of sentinel lymph node biopsy of gastric carcinoma are still unclear and controversial.
To assess the applicability of the sentinel node concept to gastric carcinoma, we retrospectively analyzed the location of metastatic lymph nodes in patients with only one or two lymph node metastases.
A total of 135 patients, who underwent gastrectomy with D2 lymphadenectomy for primary gastric adenocarcinoma between 1997 and 2001, were enrolled in this study. An average of 39 lymph nodes were resected and analyzed for each patient. Of the 135 patients, 88 (65%) were subtyped as pN+ (with lymph node metastasis); of the latter, 15 cases (pT1-3; 17% of N+ cases) showed one or two lymph node metastases. In 14 (93%) of these patients, lymph nodes directly adjacent to the primary tumor were involved. Skip metastases were only seen in one patient with cardia carcinoma and lymph node involvement of compartment II (left gastric artery).
In patients with gastric carcinoma, especially in early stage carcinoma, the phenomenon of skip metastasis is infrequent. Therefore, the sentinel node concept may be feasible in gastric cancer.
胃癌前哨淋巴结活检的可行性及诊断可靠性仍不明确且存在争议。
为评估前哨淋巴结概念在胃癌中的适用性，我们回顾性分析了仅有一或两个淋巴结转移患者的转移淋巴结位置。
本研究纳入了1997年至2001年间因原发性胃腺癌接受D2淋巴结清扫术的135例患者。每位患者平均切除并分析39个淋巴结。135例患者中，88例（65%）被分类为pN+（有淋巴结转移）；其中，15例（pT1 - 3；N+病例的17%）有一或两个淋巴结转移。在这些患者中的14例（93%），紧邻原发肿瘤的淋巴结受累。跳跃转移仅在1例贲门癌且Ⅱ区（胃左动脉）淋巴结受累的患者中见到。
在胃癌患者中，尤其是早期癌，跳跃转移现象不常见。因此，前哨淋巴结概念在胃癌中可能是可行的。
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