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目的探讨腹腔镜下定位结直肠癌前哨淋巴结(SLN)方法,以及对手术和病理分期的价值。方法选择26例腹腔镜下结直肠癌根治术患者行腹腔镜下淋巴结标记,采用HE染色检测,CK免疫组化染色检查SLN中转移癌。结果 26例腹腔镜下前哨淋巴结标记均顺利。4例(16.7%)提示淋巴结引流超出最初计划切除的边缘,需要扩大切除范围。24例(92.3%)前哨淋巴结反映腹腔淋巴结肿瘤情况;其中,8例(33.3%)发现淋巴结转移,4例(16.7%)常规病理检查为阴性,经免疫组化检查证实为阳性。结论腹腔镜下结直肠癌前哨淋巴结标记可提高结直肠癌病理分期的准确性。
Objective To investigate the method of laparoscopic localization of sentinel lymph node (SLN) in colorectal cancer and the value of surgical and pathological staging. Methods Twenty-six patients undergoing laparoscopic radical resection of colorectal cancer underwent laparoscopic lymph node dissection. HE staining and CK immunohistochemical staining were used to examine metastatic carcinoma of SLN. Results All the laparoscopic sentinel lymph nodes were marked successfully in 26 cases. Four cases (16.7%) suggested that the lymph nodes were draining beyond the margin of the original planned resection and that the extent of resection needed to be expanded. Sentinel lymph nodes were found in 24 cases (92.3%). Lymph node metastases were found in 8 cases (33.3%), and negative in 4 cases (16.7%). The positive results were confirmed by immunohistochemistry. Conclusions Sentinel lymph node marking of colorectal cancer can improve the accuracy of pathological staging of colorectal cancer.