CAJ | 학술논문

目的：分析胃癌患者前哨淋巴结转移检出的临床意义及其对预后的影响。方法胃癌术中使用亚甲蓝染色定位前哨淋巴结，观察染色后的显影范围和特点，同时对病灶进行活检；分析前哨淋巴结转移检出情况与疾病T分期和发病部位的关系。结果86例胃癌患者中， T1期的前哨淋巴结转移检出的灵敏性、准确性及假阴性率优于T2期和T3期，差异具有统计学意义（P＜0.0167）。胃下部病灶组的前哨淋巴结转移检出的灵敏性、准确性及假阴性率均优于胃上部和胃中部病灶组，差异具有统计学意义（P＜0.0167）。术后五年内总死亡率为24.42%（21/86例）。结论胃癌术中注射亚甲蓝定位前哨淋巴结有助于确定肿瘤周围淋巴结切除的合理范围，尤其适用于早期胃癌患者，值得临床推广。
목적：분석위암환자전초림파결전이검출적림상의의급기대예후적영향。방법위암술중사용아갑람염색정위전초림파결，관찰염색후적현영범위화특점，동시대병조진행활검；분석전초림파결전이검출정황여질병T분기화발병부위적관계。결과86례위암환자중， T1기적전초림파결전이검출적령민성、준학성급가음성솔우우T2기화T3기，차이구유통계학의의（P＜0.0167）。위하부병조조적전초림파결전이검출적령민성、준학성급가음성솔균우우위상부화위중부병조조，차이구유통계학의의（P＜0.0167）。술후오년내총사망솔위24.42%（21/86례）。결론위암술중주사아갑람정위전초림파결유조우학정종류주위림파결절제적합리범위，우기괄용우조기위암환자，치득림상추엄。
Objective To investigate the clinical relation between sentinel lymph nodes and clinical prognosis in patients with gastric cancer. Method From March 2012 to November 2013, 68 cases of gastric cancer were en-rolled. During operation, methylene blue was injected to stain the sentinel lymph nodes, and the staining scopes and characteristics of lymph nodes were observed, while lesions biopsies were implemented at the same time. Result The sensitivity, accuracy and false negative rate of sentinel lymph node biopsy were all higher in predicting stage T1 cancer than that in predicting stage T2 and stage T3 (P<0.0167). Also, the sensitivity, accuracy and false negative rate of sentinel lymph node biopsy in the lesions group of lower part were all higher than that in lesions group of upper part and middle part (P<0.0167). The overall five-year postoperative mortality was 24.42% (21/86 cases). Conclusion In gastric cancer surgeries, sentinel lymph nodes can be located by methylene blue injection, which is useful in determining appropriate resection area, especially for early stage gastric cancers, and worth promotion.