胃癌前哨淋巴结体外检测的临床意义
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程黎阳, 陈晓东, 谢正勇, 周洪锋, 钟世镇
胃癌;前哨淋巴结;测图,程黎阳，谢正勇，周洪锋，,陈晓东，,钟世镇，,通讯作者：,Clinicalsignificanceofexvivodetectionofsen
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程黎阳，谢正勇，周洪锋，广州军区广州总医院普通外科 广东省广州市 510010
陈晓东，广州军区广州总医院病理科 广东省广州市 510010
钟世镇，南方医科大学临床解剖研究所 广东省广州市 510515
广东省自然科学基金资助项目，No. 032204
通讯作者：程黎阳，510010，广州市流花路111号，广州军区广州总医院普通外科. chliyang2001@yahoo.com
电话：020-36653547
收稿日期：2005-02-22 接受日期：2005-07-15
Clinical significance of ex vivo detection of sentinel lymph node in gastric cancer
Li-Yang Cheng, Xiao-Dong Chen, Zheng-Yong Xie, Hong-Feng Zhou, Shi-Zhen Zhong
Li-Yang Cheng, Zheng-Yong Xie, Hong-Feng Zhou, Department of General Surgery, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou 510010, Guangdong Province, China
Xiao-Dong Chen, Department of Pathology, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou 510010, Guangdong Province, China
Shi-Zhen Zhong, Institute of Clinical Anatomy of Nanfang Medical University, Guangzhou 510515, Guangdong Province, China
Supported by Nature Science Foundation of Guangdong Province, No. 032204
Correspondence to: Dr. Li-Yang Cheng, Department of General Surgery, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou 510010, Guangdong Province, China. chliyang2001@yahoo.com
Received: 2005-02-22 Accepted: 2005-07-15
Abstract
AIM: To investigate the feasibility of ex vivo sentinel lymph node (SLN) mapping and its clinical significance in improving the staging of gastric cancer.
METHODS: Nineteen patients received curative resection of primary gastric cancer with extended lymph node dissection were included in this study. Gastric specimens were submucosally or subserosally injected with 10 g/L Patent Blue. The blue-stained SLNs were excised for routine pathological examination (hematoxylin and eosin staining). The SLNs, which were negative after HE staining, were further examined by cytokeratin immunohistochemistry.
RESULTS: The SLNs were identified in 89.5%(17/19) cases, with a mean number of 1.4 (1-3) for each case. After HE staining, the accuracy of the SLNs in diagnosis of the regional lymph node metastasis was 70.5% (12/17), and the false-negative rate was 38.4%. However, one case (25%) was upstaged by cytokeratin immunohistochemistry. Thus, the diagnostic accuracy increased to 88.2% and the false-negative rate decreased to 14.2%.
CONCLUSION: Ex vivo SLN mapping in gastric cancer is technically feasible and may upstage some of the gastric cancer.
Key Words: Gastric cancer; Sentinel lymph node; Mapping
Cheng LY, Chen XD, Xie ZY, Zhou HF, Zhong SZ. Clinical significance of ex vivo detection of sentinel lymph node in gastric cancer. Shijie Huaren Xiaohua Zazhi 2005;13(17):2156-2159
摘要
目的：探讨胃癌前哨淋巴结(sentinel lymph node，SLN)体外测图技术的可行性及其对提高胃癌淋巴结病理分期准确性的临床意义.
方法：整块切除的新鲜胃癌标本19例病灶周围浆膜或粘膜下注入10 g/L专利蓝，将标本内蓝染淋巴结视为SLN，予以切除行常规病理检查，对阴性结果者进一步行细胞角蛋白免疫组化(immunohistochemistry ......
程黎阳，谢正勇，周洪锋，广州军区广州总医院普通外科 广东省广州市 510010
陈晓东，广州军区广州总医院病理科 广东省广州市 510010
钟世镇，南方医科大学临床解剖研究所 广东省广州市 510515
广东省自然科学基金资助项目，No. 032204
通讯作者：程黎阳，510010，广州市流花路111号，广州军区广州总医院普通外科. chliyang2001@yahoo.com
电话：020-36653547
收稿日期：2005-02-22 接受日期：2005-07-15
Clinical significance of ex vivo detection of sentinel lymph node in gastric cancer
Li-Yang Cheng, Xiao-Dong Chen, Zheng-Yong Xie, Hong-Feng Zhou, Shi-Zhen Zhong
Li-Yang Cheng, Zheng-Yong Xie, Hong-Feng Zhou, Department of General Surgery, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou 510010, Guangdong Province, China
Xiao-Dong Chen, Department of Pathology, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou 510010, Guangdong Province, China
Shi-Zhen Zhong, Institute of Clinical Anatomy of Nanfang Medical University, Guangzhou 510515, Guangdong Province, China
Supported by Nature Science Foundation of Guangdong Province, No. 032204
Correspondence to: Dr. Li-Yang Cheng, Department of General Surgery, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou 510010, Guangdong Province, China. chliyang2001@yahoo.com
Received: 2005-02-22 Accepted: 2005-07-15
Abstract
AIM: To investigate the feasibility of ex vivo sentinel lymph node (SLN) mapping and its clinical significance in improving the staging of gastric cancer.
METHODS: Nineteen patients received curative resection of primary gastric cancer with extended lymph node dissection were included in this study. Gastric specimens were submucosally or subserosally injected with 10 g/L Patent Blue. The blue-stained SLNs were excised for routine pathological examination (hematoxylin and eosin staining). The SLNs, which were negative after HE staining, were further examined by cytokeratin immunohistochemistry.
RESULTS: The SLNs were identified in 89.5%(17/19) cases, with a mean number of 1.4 (1-3) for each case. After HE staining, the accuracy of the SLNs in diagnosis of the regional lymph node metastasis was 70.5% (12/17), and the false-negative rate was 38.4%. However, one case (25%) was upstaged by cytokeratin immunohistochemistry. Thus, the diagnostic accuracy increased to 88.2% and the false-negative rate decreased to 14.2%.
CONCLUSION: Ex vivo SLN mapping in gastric cancer is technically feasible and may upstage some of the gastric cancer.
Key Words: Gastric cancer; Sentinel lymph node; Mapping
Cheng LY, Chen XD, Xie ZY, Zhou HF, Zhong SZ. Clinical significance of ex vivo detection of sentinel lymph node in gastric cancer. Shijie Huaren Xiaohua Zazhi 2005;13(17):2156-2159
摘要
目的：探讨胃癌前哨淋巴结(sentinel lymph node，SLN)体外测图技术的可行性及其对提高胃癌淋巴结病理分期准确性的临床意义.
方法：整块切除的新鲜胃癌标本19例病灶周围浆膜或粘膜下注入10 g/L专利蓝，将标本内蓝染淋巴结视为SLN，予以切除行常规病理检查，对阴性结果者进一步行细胞角蛋白免疫组化(immunohistochemistry ......
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