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目的研究前哨淋巴结活检(SLNB)技术是否可以应用于胃癌根治术中。方法筛选符合实施SLNB条件的胃癌患者;实施SLNB;标记前哨淋巴结(SLN);行规范性胃癌根治术;对SLN、非前哨淋巴结(n-SLN)和切除的胃癌组织采用常规HE染色法进行病理检查。结果76例胃癌患者行SLNB,有66例检到SLN,成功率为86.84%(66/76)。在66例SLNB成功的胃癌患者中有35例常规病理检查阳性,31例阴性。在31例阴性患者中,有13例区域淋巴结检测为阳性即假阴性,假阴性率为27.10%(13/48),余18例区域淋巴结检测也呈阴性即真阴性,SLNB对于区域淋巴结预测的准确性是80.30%(53/66),敏感性是72.90%(35/48),特异性为100.00%(18/18)。结论SLNB技术可以应用于T1、T2期胃癌根治术中。
Objective To investigate whether sentinel lymph node biopsy (SLNB) can be applied in radical resection of gastric cancer. Methods The patients with gastric cancer who were eligible for SLNB were screened, SLNB was performed, and sentinel lymph node (SLN) was labeled. Radical surgery of gastric cancer was performed. The pathological changes of SLN, non-sentinel lymph node (n-SLN) an examination. Results Sixty-six patients with gastric cancer underwent SLNB. Sixty-six SLNs were detected with a success rate of 86.84% (66/76). Of the 66 SLNB patients with gastric cancer, 35 were routinely pathologically positive and 31 were negative. Among the 31 negative patients, 13 cases had positive or false-negative lymph nodes, the false-negative rate was 27.10% (13/48), and the other 18 cases with negative regional lymph nodes were also negative. The predictive value of SLNB for regional lymph nodes The accuracy was 80.30% (53/66), the sensitivity was 72.90% (35/48) and the specificity was 100.00% (18/18). Conclusion SLNB technique can be used in radical resection of T1 and T2 gastric cancer.