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目的探讨用体外亚甲蓝作为染色剂寻找前哨淋巴结(sentinel lymph node,SLN)的方法在结直肠癌SLN定位中的临床价值。方法将根治性切除大肠癌标本,在肿块四周浆膜下注射亚甲蓝后常规固定送病理检查。蓝染的淋巴结视为SLN。结果67例患者中找到SLN的有63例(91.3%),SLN镜下转移14例(22.22%)。结肠的SLN转移阳性的诊断价值与非SLN相比差异有统计学意义(P=0.0005),但在直肠癌中SLN转移阳性的诊断价值与非SLN相比差异无统计学意义(P=0.60),且SLN转移阳性在结肠癌病例中假阴性率为11.11%,而在直肠癌病例中则高达42.86%。结论体外亚甲蓝染色寻找SLN的方法在结肠癌中的应用是有效、可靠的,但在直肠癌中的应用其可靠性值得进一步的研究。
Objective To investigate the clinical value of the method of looking for sentinel lymph node (SLN) using methylene blue as stain in SLN of colorectal cancer. Methods Radical resection of colorectal cancer specimens, subserosal injection of methylene blue after the routine fixed sent pathological examination. Blue-stained lymph nodes are considered SLNs. Results Sixty-three (91.3%) SLNs were found in 67 patients and 14 (22.22%) SLNs. The diagnostic value of colonic SLN metastasis was significantly different from that of non-SLN (P = 0.0005), but the diagnostic value of SLN metastasis in colorectal cancer was not statistically different from that of non-SLN (P = 0.60) , And the positive rate of SLN metastasis in colon cancer cases false-negative rate was 11.11%, while in rectal cancer cases, up to 42.86%. Conclusion The application of in vitro methylene blue staining to find SLN in colon cancer is effective and reliable, but its reliability in rectal cancer deserves further study.