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背景与目的:区域淋巴结的转移状态是影响非小细胞肺癌(non-smallcelllungcancer,NSCLC)预后的重要因素之一。前哨淋巴结(sentinellymphnode,SLN)检测技术提供了一种术中快速高效检测淋巴结微转移的手段,但目前SLN技术应用于NSCLC尚不成熟。本实验旨在探索NSCLC根治术中SLN检测的可行性,评价SLN预测区域淋巴结转移状态的准确性。方法:应用染料法对50例NSCLC患者在根治术中于肺肿瘤边缘分4点(3、6、9、12点处)注入异硫蓝溶液4ml,进行SLN活检识别。结果:50例NSCLC患者中共有33例找到蓝染前哨淋巴结,检出率为66.0%。SLN发生于N1淋巴结24例(72.7%)、N2淋巴结6例(18.2%)、同时发生于N1和N2淋巴结3例(9.1%)。SLN识别的灵敏度为73.3%、假阴性率为26.7%、准确率为87.9%。结论:SLN对非小细胞肺癌肺门纵隔淋巴结转移具有预测性。
BACKGROUND & AIM: The status of regional lymph node metastasis is one of the important factors affecting the prognosis of non-small cell lung cancer (NSCLC). The Sentinellymphnode (SLN) detection technique provides a rapid and efficient means of detecting micrometastases in lymph nodes. However, the current application of SLN technique to NSCLC is not yet mature. The purpose of this study was to explore the feasibility of SLN detection in radical resection of NSCLC and evaluate the accuracy of SLN in predicting regional lymph node metastasis. Methods: Forty patients with NSCLC underwent radical SLN biopsy with 4ml of isosulfan solution on the margins of lung tumor (3,6,9,12 points) by dye method. Results: Of the 50 patients with NSCLC, 33 cases found blue-stained sentinel lymph nodes, the detection rate was 66.0%. SLN occurred in 24 cases (72.7%) of N1 lymph nodes, 6 cases of N2 lymph nodes (18.2%), and 3 cases (N1.1%) of N1 and N2 lymph nodes. The sensitivity of SLN identification was 73.3%, the false negative rate was 26.7% and the accuracy was 87.9%. CONCLUSIONS: SLN is predictive of hilar mediastinal lymph node metastasis in non-small cell lung cancer.