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目的探讨结直肠癌前哨淋巴结的检测及其对淋巴结转移的预测,用于指导手术范围。方法术中注射异硫蓝方法对43例结肠癌患者进行手术中前哨淋巴结的临床研究,手术中取前哨淋巴结作快速冰冻病理并与术后常规蜡块病理相对照,观察冰冻病理前哨淋巴结转移与常规病理肠系膜淋巴转移的相关性,及其对肠系膜淋巴结转移的预测价值。结果43例结直肠癌病人中,42例确定了前哨淋巴结,前哨淋巴结活检成功率97.7%。42例病人共检出淋巴结142个,检出前哨淋巴结35个。将前哨淋巴结冰冻病理与常规病理结果对照,42例结肠癌病人中15例患者证实淋巴结有转移,13例有前哨淋巴结转移,其中9例有非前哨淋巴结转移,4例无非前哨淋巴结转移;29例无前哨淋巴结转移,其中27例无非前哨淋巴结转移,2例有非前哨淋巴结转移。检出特异性为100%(27/27),敏感性为86.7%(13/15),前哨淋巴结假阴性率为13.3%(2/15)。结论检测前哨淋巴结对结肠癌淋巴结转移有重要价值,可以用于指导临床手术。
Objective To investigate the detection of sentinel lymph node in colorectal cancer and its prediction of lymph node metastasis to guide the scope of surgery. Methods Thirty-six patients with colon cancer undergoing intraoperative resection of sentinel lymph node were enrolled in this study. Sentinel lymph nodes were collected for fast freezing pathology and routine paraffin block pathology. The pathological changes of sentinel lymph node metastasis Routine pathological mesenteric lymph node metastasis, and its predictive value of mesenteric lymph node metastasis. Results Of the 43 patients with colorectal cancer, 42 sentinel lymph nodes were confirmed, and the successful rate of sentinel lymph node biopsy was 97.7%. A total of 142 lymph nodes were detected in 42 patients, and 35 sentinel lymph nodes were detected. Sentinel lymph node frost pathology and routine pathological results of control, 42 cases of colon cancer in 15 patients confirmed lymph node metastasis, 13 cases of sentinel lymph node metastasis, of which 9 cases of non-sentinel lymph node metastasis, 4 cases of non-sentinel lymph node metastasis; 29 cases There were no sentinel lymph node metastases, of which 27 had non-sentinel lymph node metastases and 2 had non-sentinel lymph node metastases. The specificity was 100% (27/27), the sensitivity was 86.7% (13/15), and the sentinel lymph node false negative rate was 13.3% (2/15). Conclusion Detection of sentinel lymph nodes has important value for lymph node metastasis of colon cancer and can be used to guide clinical operation.