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目的确定胃癌前哨淋巴结术中标识的可行性及其预测各期胃癌淋巴结转移情况的准确性。方法使用亚甲蓝对 57例胃癌 (T1 、T2 、T3期 )患者行前哨淋巴结术中标识。随后对患者行根治性胃全切除术及根治性胃近、远侧次全切除术。且于术中均行不同范围的胃周围淋巴结清除。结果 57例中有 54例 (94.8% )成功检测出前哨淋巴结。 2 8例患者有淋巴结转移 ,其中 6例存在前哨淋巴结转移 ,3例非前哨淋巴结转移 ,另有 1 9例存在前哨淋巴结及非前哨淋巴结转移。由前哨淋巴结状态预测胃周淋巴结转移情况的敏感性为 89.3 % (2 5/ 2 8) ,特异性为 1 0 0 % ,准确率为 94.4 % (51 /54)。结论前哨淋巴结术中能够准确预测胃癌患者的淋巴结转移状况。可减小手术范围 ,降低患者术后并发症的发生率 ;前哨淋巴结术中标识有望在手术治疗淋巴结转移阴性的胃癌患者中 ,尽可能免除常规淋巴结清扫
Objective To determine the intraoperative landmark of sentinel lymph node in gastric cancer and its accuracy in predicting lymph node metastasis of gastric cancer at various stages. Methods Methylene blue was used to detect intraoperative markers of sentinel lymph node in 57 cases of gastric cancer (T1, T2, T3). Subsequent patients with radical gastrectomy and radical gastric proximal and distal total subtotal resection. And in the operation of different ranges of gastric lymph node clearance. Results Seventy-five out of 57 patients (94.8%) successfully detected sentinel lymph nodes. Twenty-eight patients had lymph node metastases, including 6 cases of sentinel lymph node metastasis, 3 cases of non-sentinel lymph node metastasis and the other 19 cases of sentinel lymph node and non-sentinel lymph node metastasis. The sensitivity of sentinel lymph node status to predict gastric lymph node metastasis was 89.3% (25/28), specificity was 100%, and the accuracy was 94.4% (51/54). Conclusions Sentinel lymph node surgery can accurately predict the status of lymph node metastasis in patients with gastric cancer. Can reduce the scope of surgery and reduce the incidence of postoperative complications in patients; sentinel lymph node surgery is expected in the surgical treatment of patients with negative lymph node metastasis of gastric cancer, as far as possible to avoid the conventional lymph node dissection