Validation Study of Radio-Guided Sentinel Lymph Node Navigation in Esophageal Cancer
Validation Study of Radio-Guided Sentinel Lymph Node Navigation in Esophageal Cancer
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DOI：
10.1097/sla.0b013e3181a38e89
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发表时间：
2009-05-01
影响因子：
9
通讯作者：
Kitagawa, Yuko
中科院分区：
文献类型：
--
作者：
Takeuchi, Hiroya;Fujii, Hirofumi;Kitagawa, Yuko
背景资料：前哨淋巴结（SLN）的放射引导检测已被用于预测黑色素瘤和乳腺癌患者的区域淋巴结转移。然而，SLN假说对食管癌的有效性仍存在争议。本研究的目的是评估放射导向SLN标测在食管癌中的可行性和准确性。方法：75例术前诊断为T1 NOMO或T2 NOMO原发性食管癌的患者入选。术前内镜下注射99 m锝锡胶体，术前行淋巴结造影及γ-探头定位放射性前哨淋巴结。所有患者均行标准根治性食管切除加淋巴结清扫术，所有切除的淋巴结均行常规病理检查。每例患者的平均前哨淋巴结数为4.7。33例有淋巴结转移者中29例（88%）SLN阳性。根据SLN状态诊断的准确率为94%（67/71）。确定的SLN的分布广泛传播，从颈部到腹部areas.Conclusions：这项研究表明，放射性引导下的SLN映射是一个准确的诊断程序，用于检测淋巴结转移的早期食管癌患者。
Background: Radio-guided detection of sentinel lymph nodes (SLN) has been used to predict regional lymph node metastasis in patients with melanoma and breast cancer. However, the validity of the SLN hypothesis is still controversial for esophageal cancer. The aim of this study is to evaluate the feasibility and accuracy of radio-guided SLN mapping for esophageal cancer.Methods: Seventy-five consecutive patients who were diagnosed preoperatively with T1NOMO or T2NOMO primary esophageal cancer were enrolled. Endoscopic injection of technetium-99m tin colloid was performed before surgery and radioactive SLNs were identified with preoperative lymphoscintigraphy and gamma probe. Standard radical esophagectomy with lymphadenectomy was performed in all patients and all resected nodes were evaluated by routine pathologic examination.Results: SLNs were identified successfully in 71 (95%) of 75 patients. The mean number of identified SLNs per case was 4.7. Twenty-nine (88%) of 33 cases with lymph node metastasis showed positive SLNs. The diagnostic accuracy based on SLN status was 94% (67/71). Distribution of identified SLNs was widely spread from the cervical to abdominal areas.Conclusions: This study reveals that radio-guided SLN mapping is an accurate diagnostic procedure for detecting lymph node metastasis in patients with early-stage esophageal cancer.