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目的探索进展期胃痛(AGC)淋巴结示踪方法。方法胃角部 AGC 有第3组淋巴结(No.3)转移的根治术中,向 No.3转移结节内或结节周边注射染料,切取近转移结节的二级前淋巴结(SSLN)活检。常规 HE 染色及免疫组化检查。结果 46例胃角部 AGC 中,找到 SSLN38例,检出率82.6%(38/46),病理及免疫组化检查 SSLN 有转移30例,阳性率78.9%(30/38),找到 SSLN68枚,有转移52枚,SSLN 阳性率76.4%(52/68)。SSLN 分布为:第7、5、4、6、9、8组 SSLN 枚数依次为40、9、7、5、4、3枚,病理及免疫组化检查阳性个数及阳性率分别是31(77.5%)、9(100%)、5(71.4%)、4(80.0%)、2(50.0%)、1(33.3%)。肿瘤大小、分化程度与 SSLN 的阳性发现无统计学意义。结论SSLN 示踪技术拓展了 SLN 示踪技术的应用范围,为不同病期的胃痛淋巴结研究提供一种新思路;SSLN 示踪技术对指导 AGC 合理科学及个体化淋巴结清扫提供了重要的参考依据。
Objective To explore the method of lymph node tracing of advanced gastric pain (AGC). Methods In the radical gastrectomy of group 3 with lymph node (No.3) metastasis in the corner of the stomach, injection of dye in or around the nodal metastasis of No. 3 was performed, and the biopsies of the secondary lymph nodes (SSLN) of the metastatic nodules . Routine HE staining and immunohistochemistry. Results There were 38 cases of SSLN found in 46 cases of AGC, and the detection rate was 82.6% (38/46). There were 30 cases of SSLN metastasis in pathological and immunohistochemical examination, the positive rate was 78.9% (30/38) There were 52 metastases, SSLN positive rate of 76.4% (52/68). The distribution of SSLN was as follows: the number of SSLNs in groups 7, 5, 4, 6, 9 and 8 were 40, 9, 7, 5, 4 and 3, respectively. The positive number and positive rate of pathological and immunohistochemical examination were 31 77.5%), 9 (100%), 5 (71.4%), 4 (80.0%), 2 (50.0%), 1 (33.3%). Tumor size, differentiation and SSLN positive findings were not statistically significant. Conclusion The SSLN tracing technique extends the application range of SLN tracing technique and provides a new idea for the study of gastric nodal lymph nodes in different stages. The SSLN tracing technique provides an important reference for guiding scientific and personalized lymph node dissection of AGC.