摘要
目的 探讨经直肠上动脉注射美蓝行直肠系膜及淋巴结染色后淋巴结检出率的变化,同时在此基础上检测淋巴结的微转移情况。方法对30例直肠癌患者术中经直肠上动脉插管注射美蓝6 ml,使直肠系膜及各组淋巴结染色,统计淋巴结数目,与同期32例常规直肠癌根治术淋巴结数目对比,比较其淋巴结检出率;对美蓝染色组淋巴结行癌胚抗原(CEA)免疫组织化学染色,检测其微转移情况。结果美蓝染色组肠旁淋巴结、肠系膜淋巴结、肠系膜根部淋巴结检出数目均明显大于常规根治术组(P均<0.05);美蓝染色组淋巴结常规病理检查阴性者经CEA免疫组化染色其转移阳性率增加(8.47％),13例Duke's B期患者经淋巴结CEA免疫组织化学染色需重新确定为Duke'sC期(46.7％)。结论术中经直肠上动脉注射美蓝行淋巴结染色能提高淋巴结检出率;对常规病理检查阴性的淋巴结行CEA免疫组织化学染色检查其微转移灶,能提高淋巴结阳性检出率,使病理分期更准确,从而指导进一步治疗。
Objective To discuss the variety of inspecting rate in lymph nodes after the staining of mesenrectem and the lymph nodes by means of injecting methylene blue via rectalis superior artery, and simultaneously, to study the micrometastasis of the lymph nodes. Methods Methlene blue (6 ml) was injected into rectalis superior artery in operation in 30 patients, making the mesenrectem and the lymph nodes stained and stating the number of lymph nodes. The eliminate rates were compared with that of another 32 patients in whom the routine radical operation of rectal cancer was performed in the same period. The micrometastasis of the lymph nodes in methylene blue staining group was studied by means of detecting the lymph nodes with immunohistochemistry of CEA. Results The eliminated number of lymph nodes beside the intestine, in the mesenrectem and around the roof of the mesenrectem was significantly greater than that in routine radical operation group ( P < 0.05), and the positive rate of micrometastasis in lymph nodes after immunohistochemistry with CEA in methylene blue staining group was increased (8.47% ) . Thirteen patients at stage of Duke's B needed to change to Duke' s C. Conclusion Staining the lymph nodes with methylene blue by injecting it via rectalis superior artery in operation can increase the eliminate rate; To inspect the micrometastasis of the lymph nodes which were negative for routine pathology examined by CEA immunohistochemistry can increase positive rate, making the pathology staging more accurate, furthermore, instructing the treatment in next step.
出处
《中华实验外科杂志》
CAS
CSCD
北大核心
2004年第9期1139-1140,共2页
Chinese Journal of Experimental Surgery
基金
深圳市科技局基金资助项目(200304046)
