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目的探讨结肠癌术中定位前哨淋巴结(SLN)的可行性及在分析结肠癌淋巴结转移中的临床意义。方法对86例结肠癌患者进行术中异硫蓝定位检测SLN,术后常规病理检测所有淋巴结;对所有SLN进行连续切片病理检测和免疫组织化学检测。结果86例结肠癌中检出SLN82例,检出率为95.3%。SLN转移患者共39例,而常规病理检测淋巴结转移患者26例。82例结肠癌共检出SLN182枚,占全部区域淋巴结的16.4%(182/1107),平均每例(2.0±0.29)枚。SLN转移率明显高于其它区域淋巴结(P<0.01)。结论进行结肠癌术中定位SLN是可行的,且能明显提高结肠癌淋巴结检出阳性率。
Objective To investigate the feasibility of locating sentinel lymph node (SLN) during colon surgery and its clinical significance in the analysis of lymph node metastasis of colon cancer. Methods The intraoperative SLN detection was performed on 86 cases of colon cancer patients. All lymph nodes were routinely pathologically detected. All SLNs were consecutively sectioned for pathological examination and immunohistochemistry. Results Among 82 cases of colon cancer, 82 cases of SLN were detected, and the detection rate was 95.3%. Thirty-nine patients with SLN metastasis were included, while 26 patients with lymph node metastasis were detected by routine pathology. In 82 cases of colon cancer, 182 SLNs were detected, accounting for 16.4% (182/1107) of all regional lymph nodes, with an average of (2.0±0.29) pieces per patient. The SLN metastasis rate was significantly higher than other regional lymph nodes (P<0.01). Conclusions It is feasible to locate SLN during colon cancer surgery, and it can significantly increase the positive rate of lymph node detection in colon cancer.