摘要
胃癌术后恰当的淋巴结检出数目及准确的阳性淋巴结个数是实现患者精准分期的必要保障之一.在NCCN指南推荐的最低15枚淋巴结检出数目基础上,尽可能多地检出可使患者更多获益.手术因素、患者、肿瘤病理学特征、术后分拣均可影响淋巴结检出数目.相比于传统触摸法,去脂技术和亚甲蓝染色能提高淋巴结检出率;纳米碳示踪法有利于显示淋巴管脉络,有助于检出微小淋巴结.解放军总医院普通外科的阶段性研究成果表明,由手术医师参与的二次分检能提高淋巴结检出数目.为建立规范和标准,淋巴结检出流程还需更多探索和研究.
The nmnber of lymph node dissection and positive lymph nodes are the necessary guarantees for patients to achieve accurate staging after gastric cancer surgery.On the basis of the minimum number of lymph nodes dissection recommended by the NCCN guidelines,as many as possible lymph node yields will be most likely to benefit patients.Many factors can influence the number of lymph node yields including surgery,patient,tumor pathology and postoperative sorting factors.Compared with traditional manual nodal dissection method,fat-clearing technique and methylene blue staining method can improve the number of lymph nodes detection,while lymphatic tracers,such as carbon nanoparticles,are conducive to show lymphatic vessels,contributing to the dissection of small lymph nodes.The initial results from People＆#39;s Liberation Army General Hospital show that lymph node packet submission after isolation by surgeon yields more lymph nodes.For the establishment of standards,lymph node retrieval-related procedures need further in-depth exploration and investigation.
出处
《中华外科杂志》
CAS
CSCD
北大核心
2017年第4期255-259,共5页
Chinese Journal of Surgery
关键词
胃肿瘤
淋巴结
病理学
外科
肿瘤分期
Stomach neoplasms
Lymph nodes
Pathology,surgical
Neoplasm staging
