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比较 SLNM 与常规手术在 12 枚以下和 12 枚以上淋巴结清扫的结肠癌患者中阳性淋巴结检出率的差异。

Comparison of nodal positivity between SLNM vs conventional surgery in colon cancer patients with <12 and ≥12 lymph nodes harvested.

机构信息

Department of Surgical Oncology, McLaren Regional Medical Center, Flint, MI, USA.

出版信息

Am J Surg. 2011 Aug;202(2):207-13. doi: 10.1016/j.amjsurg.2010.06.028. Epub 2011 Feb 1.

Abstract

BACKGROUND

Examination of ≥12 lymph nodes (LNs) ensures accurate staging in colon cancer. The aim of this study was to compare nodal positivity between sentinel LN mapping (SLNM) and conventional surgery in patients with <12 and ≥12 LNs harvested.

METHODS

From 1993 to 2008, 407 and 380 patients with colon cancer underwent SLNM and conventional surgery, respectively. Total LNs harvested and nodal positivity were analyzed. Patients were grouped according to number of LNs harvested: 2 to 11, 12 to 25, or >25.

RESULTS

The average numbers of LNs harvested in the groups with 2 to 11, 12 to 25, and >25 LNs harvested for SLNM and conventional surgery, respectively, were 8.3 and 7.1 (P < .0001), 17.2 and 16.5 (P = .09), and 34.2 and 32.1 (P = .40). Nodal positivity for SLNM and conventional surgery in the groups with <12 and ≥12 LNs harvested was 42% and 29% (P = .01) and 50% and 36% (P = .003), respectively. Overall nodal positivity was 47% for SLNM and 32% for conventional surgery (P < .0001). When SLNM with 2 to 11 LNs was compared with conventional surgery with 12 to 25 LNs, nodal positivity was 42% versus 36% (P = .35).

CONCLUSIONS

SLNM possessed higher nodal positivity compared with conventional surgery. SLNM is a valuable adjunct to accurate nodal staging in colon cancer.

摘要

背景

检查≥12 个淋巴结(LNs)可确保结肠癌的准确分期。本研究的目的是比较在采集<12 个和≥12 个 LNs 的患者中,前哨淋巴结绘图(SLNM)与常规手术之间的淋巴结阳性率。

方法

1993 年至 2008 年,407 例和 380 例结肠癌患者分别接受了 SLNM 和常规手术。分析了采集的总淋巴结数和淋巴结阳性率。根据采集的淋巴结数量将患者分为 2 至 11 个、12 至 25 个或>25 个。

结果

SLNM 和常规手术中采集 2 至 11 个、12 至 25 个和>25 个淋巴结的患者平均淋巴结数量分别为 8.3 和 7.1(P <.0001)、17.2 和 16.5(P =.09)和 34.2 和 32.1(P =.40)。采集<12 个和≥12 个淋巴结的 SLNM 和常规手术的淋巴结阳性率分别为 42%和 29%(P =.01)和 50%和 36%(P =.003)。SLNM 的总体淋巴结阳性率为 47%,常规手术为 32%(P <.0001)。当将 2 至 11 个 LNs 的 SLNM 与 12 至 25 个 LNs 的常规手术进行比较时,淋巴结阳性率为 42%比 36%(P =.35)。

结论

与常规手术相比,SLNM 具有更高的淋巴结阳性率。SLNM 是结肠癌准确淋巴结分期的有价值的辅助手段。

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