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1992年Morton将前哨淋巴结定义为原发肿瘤淋巴引流的第一站淋巴结,在其没有转移时,其他淋巴结发生跳跃性转移的机会较少。前哨淋巴结定位示踪技术主要有染色法、放射性核素法、以及两者联合的混合法。染色法操作简便、直观,其缺陷在于:注射后即可进入毛细淋巴管又可进入毛细血管,使被注射部位广泛染色,不利于病灶的判定。核素法探测时有背景信号干扰并且有放射性危害是其缺点。毛细血管壁内皮细胞间隙为30～50 nm。而毛细淋巴管壁细胞间隙达500 nm,平均粒径150 nm的纳米炭在肿瘤及周围组织注射后,滞留于引流淋巴管和淋巴结,而不能进入毛细血管,从而实现了淋巴结染色。近红外荧光与纳米技术结合后即成为能发射近红外荧光的量子点,可以在活体内定位和成像肿瘤,是纳米技术的进一步发展。将来通过对前哨淋巴结进行分子生物学标记或体循环肿瘤细胞DNA分析,前哨淋巴结特有的对判断肿瘤淋巴结转移的准确性和最小创伤性会发挥更大作用。
In 1992, Morton defined sentinel lymph node as the first lymph node in the primary tumor with lymphatic drainage. When there is no metastasis, Morton has less chance of jumping metastasis to other lymph nodes. Sentinel lymph node localization tracing techniques are mainly staining method, radionuclide method, and a combination of the two methods. Dyeing method is simple and intuitive, the drawback is that: after injection can enter the lymphatic capillaries into capillary capillaries, the injection site is widely stained, is not conducive to the determination of lesions. It is a disadvantage that background signal interference and radioactive hazard exist when detecting radionuclides. Capillary wall endothelial cell gap is 30 ~ 50 nm. The capillary lymphatic wall cell gap up to 500 nm, the average particle size of 150 nm of nano-carbon in the tumor and surrounding tissue after injection, retention in the drainage of lymphatic vessels and lymph nodes, and can not enter the capillaries, in order to achieve lymph node staining. The combination of near-infrared fluorescence and nanotechnology becomes a quantum dot capable of emitting near-infrared fluorescence, which can locate and image tumors in vivo and is a further development of nanotechnology. In the future, through the molecular biology of sentinel lymph nodes or systemic DNA analysis of sentinel lymph nodes, sentinel lymph node uniqueness plays a greater role in judging the accuracy and minimal trauma of tumor lymph node metastasis.