前哨淋巴结活检在结直肠癌中的临床应用研究

摘要

Objective To investigate the feasibility and value of clinical application of sentinel lymph node biopsyC SLN ) in colorectal cancer. Methods SLNs were mapped in the 43 cases,with methylene blue injected into subserosa,before harvested and examined by HE staining,CK-20 immunohistochemical staining to identify metastasis. Results A total of 73 SLNs among all lymph nodes( 705 ) were inspected. SLN was detected in 40 cases of 43 patients,an average of 1. 83/case. The metastases rate was higher in SLNs than in regional lymph nodes( P <0. 01 ). The sensitivity rate in immunohistochemical method was higher than that in HE staining method used to identify metastasis of SLNs, however, false negative rate of SLN status in diagnosis of node metastasis was contrary. Conclusions SLN mapping of radical surgery for colorectal cancer can be performed successfully, and predict the metastases state of the regional lymph nodes verily, which is significant in guiding colorectal resection and postoperative pathologic staging and developing a comprehensive treatment program.%目的 探讨前哨淋巴结活检(SLNB)在结直肠癌根治术中的可行性及其应用价值.方法 应用美蓝对43例结直肠癌患者行前哨淋巴结(SLN)定位活检,采用HE染色病理检查法、CK-20免疫组化染色检查法.结果 共检出淋巴结705枚,其中SLN 73枚,43例患者中40例检出SLN,平均1.83枚/例.入组患者SLN的转移率明显高于区域淋巴结的转移率(P<0.01);免疫组化检测SLN癌转移的敏感性明显高于HE染色,而假阴性明显低于后者.结论 结直肠癌根治术中SLN定位具有切实的可行性,能够预测区域淋巴结的转移状况,对指导结直肠癌术中切除范围及术后病理分期和制定综合治疗方案有一定意义.