Division of General Thoracic Surgery, Department of Surgery, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
Surg Today. 2011 Jul;41(7):889-95. doi: 10.1007/s00595-010-4528-1. Epub 2011 Jul 12.
Sentinel node (SN) identification in patients with lung cancer is useful not only to minimize lymph node dissection, but also to target the best lymph nodes for intraoperative frozen section during segmentectomy. Since 2000, we have identified the SN in lung cancer patients using radioisotope (RI). This review presents our data on SN identification, describing the following: the procedure, using a radioisotope tracer; the flow of Tc-99 tin colloid after the injection; the characteristics of patients whose SNs could not be identified; ex vivo SN identification; reliability of in vivo SN identification; the algorithm for reducing mediastinal lymph node dissection; the differences in SN identification between large and small radioisotope particles; SNs at segmental lymph nodes; SN navigation segmentectomy for clinical stage IA non-small cell lung cancer; and small metastasis in the SN.
前哨淋巴结(SN)在肺癌患者中的识别不仅有助于减少淋巴结清扫,还有助于在肺段切除术中针对最佳的淋巴结进行术中冷冻切片。自 2000 年以来,我们一直使用放射性同位素(RI)来识别肺癌患者的 SN。本综述介绍了我们在 SN 识别方面的数据,描述了以下内容:使用放射性同位素示踪剂的程序;注射后 Tc-99 锡胶体的流向;无法识别 SN 的患者的特征;SN 的离体识别;体内 SN 识别的可靠性;减少纵隔淋巴结清扫的算法;大、小放射性同位素颗粒之间 SN 识别的差异;肺段淋巴结的 SN;临床分期为 IA 期非小细胞肺癌的 SN 导航肺段切除术;以及 SN 中的小转移。