胃癌前哨淋巴结定位及活检技术探讨
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摘要
目的:研究并探讨对胃癌患者进行前哨淋巴结定位及活检的可行性和临床价值。方法:选取2011年1月-2015年1月笔者所在医院进行胃癌根治手术的100例患者作为研究对象,在手术过程中,使用亚甲蓝前哨淋巴结进行定位活检,对其定位活检结果进行分析,并与术后病理诊断结果进行对比。结果:100例患者中被检出前哨淋巴结转移84例,检出率为84%。术后病理诊断结果显示,100例患者中早期胃癌34例,中晚期胃癌66例;而84例被检出前哨淋巴结转移患者中,早期胃癌32例,中晚期胃癌52例。早期胃癌定位活检的敏感度为94.12%,中晚期胃癌定位活检的敏感度为78.79%,定位活检对早期胃癌的敏感度较中晚期胃癌明显更高,差异有统计学意义(P<0.05)。结论:对胃癌患者进行前哨淋巴结定位活检,具有较高的检出率,且其诊断早期胃癌的准确性高于中晚期胃癌。
Objective:To study and explore the feasibility and clinical value of the localization and biopsy of the sentinel lymph nodes in patients with gastric cancer.Method:100 cases of gastric cancer patients in our hospital were selected from January 2011 to January 2015 as the research object.During the operation,the sentinel lymph nodes of patients were analyzed by using methylene blue,and compared the results with the pathological diagnosis.Result:84 cases of the 100 patients were detected with sentinel lymph node metastasis,the detection rate was 84%.The postoperative pathological diagnosis showed that there were 34 patients had early gastric cancer,and 66 patients had advanced gastric cancer of the 100 patients;Of the 84 patients with sentinel lymph node metastasis,32 patients had early gastric cancer,and 52 patients had middle and late gastric cancer.The sensitivity of early gastric biopsy was 94.12%,and the sensitivity of biopsy was 78.79%,and the sensitivity of early gastric cancer was significantly higher than that in advanced gastric cancer(P<0.05).Conclusion:The sentinel lymph node biopsy in gastric cancer patients with high detection rate,and the accuracy of the diagnosis of early gastric cancer is higher than that of the middle and late stage.
Objective:To study and explore the feasibility and clinical value of the localization and biopsy of the sentinel lymph nodes in patients with gastric cancer.Method:100 cases of gastric cancer patients in our hospital were selected from January 2011 to January 2015 as the research object.During the operation,the sentinel lymph nodes of patients were analyzed by using methylene blue,and compared the results with the pathological diagnosis.Result:84 cases of the 100 patients were detected with sentinel lymph node metastasis,the detection rate was 84%.The postoperative pathological diagnosis showed that there were 34 patients had early gastric cancer,and 66 patients had advanced gastric cancer of the 100 patients;Of the 84 patients with sentinel lymph node metastasis,32 patients had early gastric cancer,and 52 patients had middle and late gastric cancer.The sensitivity of early gastric biopsy was 94.12%,and the sensitivity of biopsy was 78.79%,and the sensitivity of early gastric cancer was significantly higher than that in advanced gastric cancer(P<0.05).Conclusion:The sentinel lymph node biopsy in gastric cancer patients with high detection rate,and the accuracy of the diagnosis of early gastric cancer is higher than that of the middle and late stage.
引文
[1]徐惠明,朱建伟,黄宝玉,等.前哨淋巴结活检在胃癌根治术中的应用[J].现代肿瘤医学,2012,20(10):2084-2086.
[2]张希衍,史东波.前哨淋巴结检测在早期胃癌中的临床应用价值[J].中国中西医结合消化杂志,2014,22(1):16-18.
[3]陶锋,许国权,王松祥,等.前哨淋巴结检测对胃癌淋巴结转移的预测价值[J].实用肿瘤杂志,2011,26(5):500-502.
[4]柯孔亮,戴永平,郭宇,等.亚甲蓝示踪技术在胃癌前哨淋巴结活检中的应用[J].现代实用医学,2015,27(5):623-625.
[5]李宗林,姜淮芜,肖仕明,等.前哨淋巴结活检技术在胃癌外科中的应用[J].实用肿瘤杂志,2012,27(4):445-448.
[6]孟昭义,康复笑,何长青,等.吲哚菁绿,亚甲蓝联合染色标记胃癌前哨淋巴结临床分析:附32例报道[J].中外医学研究,2010,8(28):22-24.
[7]吴凯,刘伟,冯旭刚,等.86例胃癌前哨淋巴结转移的临床分析及其预后[J].癌症进展,2014,12(5):498-501.
[8]许啸声,郑民华.前哨淋巴结活检在早期胃癌淋巴结转移评估中的应用[J].外科理论与实践,2010,15(2):194-196.
[2]张希衍,史东波.前哨淋巴结检测在早期胃癌中的临床应用价值[J].中国中西医结合消化杂志,2014,22(1):16-18.
[3]陶锋,许国权,王松祥,等.前哨淋巴结检测对胃癌淋巴结转移的预测价值[J].实用肿瘤杂志,2011,26(5):500-502.
[4]柯孔亮,戴永平,郭宇,等.亚甲蓝示踪技术在胃癌前哨淋巴结活检中的应用[J].现代实用医学,2015,27(5):623-625.
[5]李宗林,姜淮芜,肖仕明,等.前哨淋巴结活检技术在胃癌外科中的应用[J].实用肿瘤杂志,2012,27(4):445-448.
[6]孟昭义,康复笑,何长青,等.吲哚菁绿,亚甲蓝联合染色标记胃癌前哨淋巴结临床分析:附32例报道[J].中外医学研究,2010,8(28):22-24.
[7]吴凯,刘伟,冯旭刚,等.86例胃癌前哨淋巴结转移的临床分析及其预后[J].癌症进展,2014,12(5):498-501.
[8]许啸声,郑民华.前哨淋巴结活检在早期胃癌淋巴结转移评估中的应用[J].外科理论与实践,2010,15(2):194-196.