胃癌的前哨淋巴结定位
Sentinel node mapping for gastric cancer.
作者信息
Rabin Igor, Chikman Bar, Halpern Zvi, Wassermann Ilan, Lavy Ron, Gold-Deutch Ruth, Sandbank Judith, Halevy Ariel
机构信息
Division of Surgery, Assaf Harofeh Medical Center, Zerifin, Israel.
出版信息
Isr Med Assoc J. 2006 Jan;8(1):40-3.
BACKGROUND
Sentinel lymph node mapping is the standard of care for patients with malignant melanoma and breast cancer. Recently, SLN mapping was introduced to the field of gastric cancer.
OBJECTIVES
To evaluate SLN mapping in patients with gastric cancer.
METHODS
In 43 patients with gastric cancer, open intraoperative subserosal dye injection in four opposing peritumoral points was used. Ten minutes following dye injection, stained LNs were located, marked and examined postoperatively from the surgical specimen.
RESULTS
SLN mapping was performed in 43 patients with gastric cancer; 782 lymph nodes were harvested and evaluated. SLNs were stained in 34 of the patients (79.1%) with a mean of 2.85 SLNs per patient. The false negative rate was 20.9%, the positive predictive value 100%, the negative predictive value 78.6% and the sensitivity 86.9%.
CONCLUSIONS
SLN mapping in patients with gastric cancer is feasible and easy to perform. SLN mapping may mainly affect the extent of lymph node dissection, and to a lesser degree gastric resection. However, more data are needed.
背景
前哨淋巴结定位是恶性黑色素瘤和乳腺癌患者的标准治疗方法。最近，前哨淋巴结定位被引入胃癌领域。
目的
评估胃癌患者的前哨淋巴结定位。
方法
对43例胃癌患者，在肿瘤周围四个相对点进行术中开放浆膜下染料注射。注射染料10分钟后，定位并标记染色的淋巴结，术后从手术标本中检查。
结果
对43例胃癌患者进行了前哨淋巴结定位；共获取并评估了782个淋巴结。34例患者（79.1%）的前哨淋巴结被染色，平均每位患者有2.85个前哨淋巴结。假阴性率为20.9%，阳性预测值为100%，阴性预测值为78.6%，敏感性为86.9%。
结论
胃癌患者的前哨淋巴结定位可行且易于实施。前哨淋巴结定位可能主要影响淋巴结清扫范围，对胃切除范围影响较小。然而，还需要更多数据。
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