The effect of colonoscopic tattooing on lymph node retrieval and sentinel lymph node mapping

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• 作者：Sanne A.L. Bartels ; Edwin S. van der Zaag ; Evelien Dekker ; Christianne J. Buskens ; Willem A. Bemelman
• 关键词：CRC ; colorectal cancer ; LN ; lymph node
• 刊名：Gastrointestinal Endoscopy
• 出版年：2012
• 出版时间：October, 2012
• 年：2012
• 卷：76
• 期：4
• 页码：793-800
• 全文大小：1090 K

文摘

| Figures/TablesFigures/Tables | ReferencesReferences<h4 class=""h4"">Backgroundh4>In colorectal cancer (CRC), colonoscopic tattooing is performed to mark the tumor site before laparoscopic surgery.<h4 class=""h4"">Objectiveh4>

To determine whether colonoscopic tattooing can be used to refine staging accuracy by increasing the lymph node (LN) yield per specimen and to determine its accuracy as a sentinel LN procedure.<h4 class=""h4"">Designh4>

Retrospective, case-control study. All LNs were microscopically examined for the presence of carbon particles.<h4 class=""h4"">Settingh4>

A university hospital and a teaching hospital.<h4 class=""h4"">Patientsh4>

A consecutive series of 95 tattooed patients who had surgery for CRC between 2005 and 2009. A series of 210 non-tattooed patients who had surgery in the same time period served as controls.<h4 class=""h4"">Main Outcome Measurementsh4>

Total number of LNs retrieved, detection rate, and sensitivity of tattooing as a sentinel node procedure.<h4 class=""h4"">Resultsh4>

A higher LN yield was observed in patients with preoperative tattooing, median (interquartile range) 15 (10-20) versus 12 (9-16), (P = .014). In multivariable analysis, the presence of carbon-containing LNs was an independent predictive factor for a higher LN yield (P = .002). The detection rate was 71 % , with a median of 5 carbon-containing LNs per specimen. If preoperative tattooing was used for sentinel node mapping, the overall accuracy of predicting LN status was 94 % . In the 24 N1 cases, there were 4 false-negative procedures (sensitivity 83 % ).<h4 class=""h4"">Limitationsh4>

Retrospective series.<h4 class=""h4"">Conclusionh4>

After tattooing of CRC, the LN yield was higher than in a control group, and it could be used as a sentinel node procedure with acceptable accuracy rates. Because LN yield and sentinel node mapping are associated with improved diagnostic accuracy of LN involvement, preoperative tattooing can refine staging.