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目的探讨结直肠前哨淋巴结(SLN)的定位方法及检测淋巴结微转移的有效方法,并分析其临床意义。方法对60例结直肠癌患者采用亚甲蓝染色法淋巴结示踪,寻找染色的SLN,切除后的SLN行HE染色和细胞角蛋白CK20免疫组化检测;并与前期直接行淋巴结清扫的60例患者对比。结果亚甲蓝组中可识别SLN者54例(90.0%),高于前期直接清扫组的24例(40.0%)(P<0.05);54例中行常规HE染色检出36例阳性,18例阴性。18例SLN阴性者行免疫组化检测,6例(33.3%)检出有微转移灶。结论联合应用亚甲蓝和细胞角蛋白CK20进行结直肠癌SLN定位优于单用其中之一种方法;免疫组化是检测淋巴结微转移的敏感方法。
Objective To investigate the localization of sentinel lymph node (SLN) in colorectal cancer and its effective method to detect micrometastasis in lymph nodes and to analyze its clinical significance. Methods 60 cases of colorectal cancer patients using methylene blue staining lymph node tracing, looking for stained SLN, resected SLN HE staining and cytokeratin CK20 immunohistochemical detection; and direct preoperative lymphadenectomy in 60 cases Patient comparison. Results In the methylene blue group, 54 cases (90.0%) could recognize SLN, which was higher than that in the direct group (24 cases) (40.0%) (P <0.05) negative. 18 cases of SLN negative immunohistochemical detection, 6 cases (33.3%) detected micrometastases. Conclusion The combination of methylene blue and cytokeratin CK20 for colorectal cancer SLN positioning is superior to either alone. Immunohistochemistry is a sensitive method to detect lymph node micrometastasis.