Sentinel node mapping and micrometastasis in patients with clinical stage IA non-small cell lung cancer.
Sentinel node mapping and micrometastasis in patients with clinical stage IA non-small cell lung cancer.
复制标题
DOI：
10.1510/icvts.2009.214197
复制
发表时间：
2009-10-01
影响因子：
--
通讯作者：
Ogawa, Junichi
中科院分区：
文献类型：
--
作者：
Ono, Takashi;Minamiya, Yoshihiro;Ogawa, Junichi
许多证据表明，有淋巴结微转移（LNMM）的非小细胞肺癌（NSCLC）患者的预后比无LNMM的患者差。因此，最好通过所有清扫淋巴结连续切片的免疫组化（IHC）评价LNMM。然而，这种劳动密集型方法在实际环境中是不可能的。因此，我们研究了我们是否能够有效地诊断LNMM使用前哨淋巴结（SN）映射。51例临床T1 N 0 M0 NSCLC患者入组本研究。然后在术中检测SN。SN标测后行肺叶切除、肺门及纵隔淋巴结清扫。所有切除的淋巴结转移灶均行苏木精-伊红（H&E）染色和免疫组化细胞角蛋白染色。SN检出率为80.4%（41/51）。患者的SN平均数量为1.8+/-1.1。使用H&E染色在两名患者中诊断出淋巴结转移。LNMM仅见于2例患者的SN。而非SN组未见微转移。根据这些结果，2例临床T1 N 0 M0 NSCLC患者迁移至T1 N1 M0。所有清扫淋巴结的微转移的评价可以由评价SN的微转移代替。我们认为，进一步的研究是必要的，以确定最有用的临床应用。
Many evidences suggest that prognosis of non-small cell lung cancer (NSCLC) with lymph node micrometastases (LNMM) is poor compared with those without LNMM. Therefore, it is better to evaluate LNMM through immunohistochemistry (IHC) of serial sectioning of all dissected lymph nodes. However, this labor-intensive approach is impossible in a practical setting. Therefore, we examined whether we are able to efficiently diagnose LNMM using the sentinel node (SN) mapping. Fifty-one patients with clinical T1N0M0 NSCLC were enrolled in this study. SNs were then detected intraoperatively. After SN mapping, lobectomy and hilar and mediastinal lymph node dissection were performed. Metastases of all dissected lymph nodes were examined by hematoxylin and eosin (H&E) staining and immunohistochemical cytokeratin staining. SN detection rate was 80.4% (41/51). Average number of SNs was 1.8+/-1.1 in a patient. Lymph node metastases were diagnosed in two patients using H&E staining. LNMM were found only in SNs of two patients. On the other hand, micrometastasis was not found in non-SN. According to these results, two patients with clinical T1N0M0 NSCLC migrated to T1N1M0. Evaluation of micrometastases of all dissected lymph nodes may be substituted by evaluating micrometastases of SNs. We believe that further studies are warranted to determine the most useful clinical applications.