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CLC number: R735.2

On-line Access: 2015-11-04

Received: 2015-03-07

Revision Accepted: 2015-08-04

Crosschecked: 2015-10-21

Cited: 0

Clicked: 7928

Citations:  Bibtex RefMan EndNote GB/T7714

 ORCID:

Zong-lin Li

http://orcid.org/0000-0002-5240-9858

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Journal of Zhejiang University SCIENCE B 2015 Vol.16 No.11 P.897-903

http://doi.org/10.1631/jzus.B1500053


Secondary sentinel lymph node tracing technique: a new method for tracing lymph nodes in radical gastrectomy for advanced gastric cancer


Author(s):  Zong-lin Li, Huai-wu Jiang, Min Song, Liang Xu, Dong Xia, Qing Liu

Affiliation(s):  Department of Gastrointestinal Surgery, the First Affiliated Hospital of Sichuan Medical University, Luzhou 646000, China; more

Corresponding email(s):   lizonglin85@163.com

Key Words:  Secondary sentinel lymph node (SSLN), Advanced gastric cancer (AGC), Individual lymphadenectomy, Survival analysis


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Zong-lin Li, Huai-wu Jiang, Min Song, Liang Xu, Dong Xia, Qing Liu. Secondary sentinel lymph node tracing technique: a new method for tracing lymph nodes in radical gastrectomy for advanced gastric cancer[J]. Journal of Zhejiang University Science B, 2015, 16(11): 897-903.

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author="Zong-lin Li, Huai-wu Jiang, Min Song, Liang Xu, Dong Xia, Qing Liu",
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doi="10.1631/jzus.B1500053"
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%A Dong Xia
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T1 - Secondary sentinel lymph node tracing technique: a new method for tracing lymph nodes in radical gastrectomy for advanced gastric cancer
A1 - Zong-lin Li
A1 - Huai-wu Jiang
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A1 - Dong Xia
A1 - Qing Liu
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Abstract: 
Objective: To explore the feasibility and clinical value of secondary sentinel lymph node (SSLN) tracing technique in radical gastrectomy for advanced gastric cancer (AGC). Methods: From January 2009 to June 2011, 247 patients who suffered from gastric angle cancer with metastasis in No. 3 group lymph nodes were divided randomly into groups A and B. Methylthioninium chloride was injected into the peripheral tissue of the metastatic No. 3 group lymph nodes of 138 patients in group A before tumor resections. SSLNs were traced and individual lymphadenectomies were carried out based on the biopsy results of the SSLNs. Standard D2 radical gastrectomies were carried out directly on 109 patients in group B. Postoperative follow-up and survival analysis were carried out for patients in both groups. Results: SSLNs were found in 114 (82.6%) patients in group A. Ninety of those patients (78.9%) demonstrated existing metastasis in SSLNs. According to Kaplan-Meier’s method, the postoperative 3-year cumulative survival rates were 63.5% and 47.5%, and the median survival time were 40 and 36 months for the patients of groups A and B, respectively (P<0.05). Conclusions: The SSLN tracing technique is feasible in radical gastrectomy for AGC. It gives surgeons important information about the terminal status of lymph node metastasis and provides some scientific basis for individual lymphadenectomy.

二级前哨淋巴结示踪技术:进展期胃癌根治术中淋巴结示踪新方法

目的:探讨二级前哨淋巴结(SSLN)示踪技术在进展期胃癌(AGC)根治术中的可行性及临床价值。
创新点:提出SSLN概念并以SSLN理论为指导对AGC 实施个体化淋巴结清扫术。
方法:将2009年1月至2011年6月于我院手术治疗的进展期胃角部癌患者247例随机分为A、B两组:A组138例于术中肿瘤切除前向第3组淋巴结转移结节边缘注亚甲蓝示踪剂,寻找并切取SSLN进行病理活检,并根据SSLN的活检结果进行个体化淋巴结清扫术;B组109例直接进行标准D2胃癌根治术。对A、B组患者进行术后随访和生存分析。
结论:SSLN示踪技术应用于AGC手术是可行的。 SSLN示踪技术可以了解AGC淋巴结转移的终末状态,对指导AGC个体化淋巴结清扫及改善预后具有重要的临床价值。

关键词:二级前哨淋巴结;进展期胃癌;个体化淋巴结清扫术;生存分析

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