胃癌前哨淋巴结活检的可行性及准确性研究
摘要
目的评估胃癌前哨淋巴结活检的可行性及准确性。方法 100例胃癌患者,将美兰染色的前哨淋巴结通过HE染色及免疫组化染色进行分析。结果 100例中94例检出前哨淋巴结,其中14例有淋巴结转移。通过HE染色检出2例T1期及1例T2期胃癌仅有非前哨淋巴结存在转移(诊断准确率分别为97.3和95.0%)。3例假阴性结果中的肿瘤直径均大于4 cm,组织学为印戒细胞癌,其中2例肿瘤病灶位于胃小弯。通过免疫组织化学方法检测,45例中有3例T1及1例T2期胃癌仅有非前哨淋巴结存在微转移(诊断准确率分别为92.1和85.7%)。结论运用美兰染料在T1期胃癌行前哨淋巴结活检具有快速、简便、较高的检出率及准确性,但是对于直径大、组织学为印戒细胞癌及胃小弯侧的胃癌不易行前哨淋巴结活检,因为可能会存在假阴性结果。
引文
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[4]Lauren P.The two histological main types of gastric carcinoma:Diffuse and so-called intestinal-type carcinoma.An attempt at a histo-clinical classification[J].Acta Pathol Microbiol Scand,1965,64:31-49.
[5]Japanese Gastric Cancer Association.Japanese classification of gastric carcinoma[J].Gastric Cancer,1998,1(1):10-24.
[6]Maruyama K,Sasako M,Kinoshita T,et al.Can sentinel node biopsy indicate rational extent of lymphadenectomy in gastric cancer surgery?Fundamental and new information on lymph-node dissection[J].Langenbecks Arch Surg,1999,384(2):149-157.
[7]Miwa K,Kinami S,Taniguchi K,et al.Mapping sentinel nodes in patients with early-stage gastric carcinoma[J].Br J Surg,2003,90(2):178-182.
[8]Hiratsuka M,Miyashiro I,Ishikawa O,et al.Application of sentinel node biopsy to gastric cancer surgery[J].Surgery,2001,129(3):335-340.
[9]Morton DL.Sentinel node mapping and an International Sentinel Node Society:current issues and future directions[J].Ann Surg Oncol,2004,11(3):137-143.