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目的:探讨大肠癌前哨淋巴结定位切除及检测淋巴结微转移的方法,并分析其临床意义。方法:对60例大肠癌患者采用亚甲蓝染法淋巴结示踪,寻找染色的前哨淋巴结,切除后行HE染色和细胞角蛋白20免疫组织化学检测,并与前期直接行淋巴结清扫的60例患者对比。结果:60例中可识别前哨淋巴结者54例,检出率为90.0%,高于前期直接清扫组的24例(40%)(P<0.05);其中常规HE染色检出36例阳性,18例前哨淋巴结阴性者应用免疫组织化学检测,6例检出有微转移灶,其阳性率大大高于对照组(P<0.05)。结论:联合应用亚甲蓝和细胞角蛋白20进行大肠癌前哨淋巴结定位优于单用其中一种方法;免疫组化方法是检测淋巴结微转移的敏感方法;前哨淋巴结定位和微转移的检测对大肠癌的治疗有重要意义。
Objective: To investigate the resection of sentinel lymph node in colorectal cancer and the detection of lymph node micrometastasis, and to analyze its clinical significance. Methods: Sixty patients with colorectal cancer were stained with methylene blue to find out the sentinel lymph nodes. After resection, HE staining and cytokeratin 20 immunohistochemistry were performed. Sixty patients with direct lymph node dissection Compared. Results: Of the 60 cases, 54 cases were found to have sentinel lymph nodes, the detection rate was 90.0%, which was higher than that of 24 cases (40%) in the direct group (P <0.05). Among them, 36 cases were positive by HE staining and 18 Cases of sentinel lymph node negative by immunohistochemistry, 6 cases were detected with micrometastases, the positive rate was significantly higher than the control group (P <0.05). Conclusions: The combined use of methylene blue and cytokeratin 20 in sentinel lymph node mapping of colorectal cancer is superior to either method alone. The immunohistochemical method is a sensitive method to detect lymph node micrometastasis. The detection of sentinel lymph node and micrometastasis on the large intestine Cancer treatment is of great importance.