Objective To understand the current research status of sentinel lymph node (SLN) biopsy in colorectal cancer. Methods Literatures about the application of SLN biopsy in the field of colorectal surgery were collected and reviewed. Results The results of SLNs biopsy accurately reflected the status of the nodal basin. Focused examination of the SLNs could identify micrometastases that might otherwise had been missed by standard histopathological analysis, thus upstaged this group of patients. Conclusion SLN biopsy represents a new and effective technique to predict the tumor status of regional lymph nodes, which offers a potential alternative to improve the accuracy of tumor staging in colorectal cancer.
ObjectiveTo summarize the current status and advances of sentinel lymph node biopsy (SLNB) technique in breast cancer. MethodsThe pertinent domestic and overseas literatures were reviewed and the localization, harvest, status assessment, indications, and complications of SLNB were analyzed. ResultsSLNB could accurately locate and pick out sentinel lymph node (SLN) in breast cancer. The development on imaging examination and pathological techniques promoted the assessment of SLN, and the indications of SLNB were expanding. The complication rate of SLNB was low and the technique could accurately predict axillary lymph node staging and direct selective axillary lymph node dissection. ConclusionsSLNB has been an important method of surgical therapy in breast cancer, but the operation process needs to be further standardized to decrease the false negative rate. Continuative attentions shall be paid to the problems such as the false positive and controversial indications.
ObjectiveTo evaluate clinical value of indocyanine green (ICG) fluorescence in sentinel lymph node (SLN) biopsy (SLNB) for breast cancer.
MethodThe SLNBs were performed in 66 patients with breast cancer,who were divided into ICG group (n=34) and methylene blue dye group (n=32) according to the tracing method.
ResultsThe SLNs were found in 59 patients,the detection rate was 89.39%(59/66).One hundred and sixty-two SLNs in 59 patients were detected,the average number of detected SLNs was 2.75.The SLNs detection rate was 97.06%(33/34) and 81.25%(26/32) in the ICG group and in the methylene blue dye group,respectively,which in the ICG group was significantly higher than that in the methylene blue dye group (P<0.05).The positive SLNs were found in 32 cases,within which was 20 cases in the ICG group,12 cases in the methylene blue dye group.The axillary lymph node metastases were found in 35 of 66 cases,within which was 21 cases in the ICG group,14 cases in the methylene blue dye group.The sensitivity and false negative rate had no significant differences between the ICG group and the methylene blue dye group (sensitivity:95.2% versus 85.7%,P>0.05;false negative rate:4.8% versus 14.3%,P>0.05).
ConclusionThe ICG fluorescence in SLNB for breast cancer has many advantages,including shorter time,simple operation,high sensitivity,and high detection rate as compared with methylene blue dye.
ObjectiveTo summarize the research progress of sentinel lymph node biopsy (SLNB) in the surgery of thyroid carcinoma in recent years.
MethodsLiteratures about the recent studies on categories of SLNB and the neck lymph node dissection conducted by SLNB in the surgery of thyroid carcinoma were reviewed following the results searched from PubMed and CNKI data base.
ResultsSLNB has a high detection rate and it is of great significance to detect the occult metastatic lymph nodes and guide the neck lymph node dissection during operation.
ConclusionThe SLNB, with its high accuracy rate on the detection of occult metastatic lymph nodes, guides neck lymph node dissection during operation in order that it can maximize the benefits of patients.
Objective To summarize and analyze the different views on the extent of lymphadenectomy in gastric cancer, and ways or methods to dissolve the disagreements. Methods The reports and advances on lymphadenectomy in gastric carcinomas were collected and reviewed.Results Eastern and western scholars presented different view on lymph nodes dissection in gastric cancers because of the difference in nationalty,studying method and operating technique.Conclusion Although extended lymph node dissection for gastric cancers are supported by more and more reports, it is difficult to evaluate the role exactly. Searchers over the world should learn from each other and explore further in order to develop guiding principles in the end.
ObjectiveTo explore the value of fluorescence tracer technique in sentinel lymph node (SLN) orientation of cN0 papillary thyroid cancer.
MethodsThe total clinical data of 40 cT1-3N0M0 thyroid cancer patients admitted from January 2015 to January 2016 in our hospital were collected, and the SLN with indocyanine green (ICG) as fluorescent trace agent were observed and detected, and the effect of ICG detecting SLN and the guide role of SLNB on the dissection of the central area of neck lymph nodes by intraoperative frozen biopsy pathology and postoperative paraffin pathology were analyzed.
ResultsA total of 40 thyroid cancer patients were treated by SLNB and then conducted by the dissection of the central area of neck lymph nodes, and 37 cases detected SLN, so the detection rate was 92.5% (37/40). And a total of 98 SLNs were detected, 1-5 for each case, average of 2.65/case. Intraoperative frozen pathological detected 28 cases of patients with metastases in SLN, and 9 patients without metastasis, including 1 case with postoperative pathology detecting micrometastasis in SLN and other 8 cases without metastasis in the central area of neck lymph nodes. Three cases who were not detected the SLN showed no metastases in final postoperative paraffin pathology. The SLNB of ICG fluorescent tracer was with a sensitivity of 96.6% (28/29), false-negative rate of 3.45% (1/29).
ConclusionThe fluorescent tracer technique can guide the dissection of the central of neck lymph node of cN0 thyroid cancer patients accurately with a high detection rate and advantages of high sensitivity in detecting the SLN of thyroid cancer.
Objective To identify the feasibility of the lymphatic mapping and sentinel node biopsy (SLNB) in patients with breast cancer and to examine whether the characteristics of the sentinel lymph node (SLN) accurately predict the status of axillary lymph node.MethodsFrom March to October 2000, 32 patients with breast cancer were evaluated at the Sichuan Provincial People’s Hospital. Lymphatic mapping was performed using Methlene Blue. A SLN was defined as any blue node. Thirtytwo patients, with breast cancer underwent a complete axillary lymph node resection (ALNR) following SLN biopsy. Subsequently, all SLNs and ALNs were examined by both Hamp;E staining as well as immunohistochemical staining for cytokeratin. ResultsLymphatic mapping was successful in identifying the SLN in 26/32(81.25%) cases of nodes at level Ⅰ. Of the 26 patients mapped successfully, 10 had metastasis to the SLNs.In 3 cases that SLNs were positive, but other axillary lymph nodes were negative. In 2 cases that the SLNs were negative, but other axillary lymph nodes were positive. The sensitivity of SLNB using Methlene Blue in this study was 77.78%(7/9), accuracy 80.77%(21/26), specificity 82.35%(14/17), and false negative rate 22.22%(2/9). ConclusionSLN can predict the status of the axillary lymph nodes reliably. However, the efficacy of SLNB in the setting of randomized, prospective trials must be tested first before abandoning axillary lymph node resection as the standard of care.
Objective To investigate the feasibility and operation effect of endoscopic sentinel lymph node biopsy （SLNB） in breast cancer. Methods The data of 410 breast cancer patients who underwent SLNB （including 107 patients with endoscopy and 303 with open operation） were analyzed in our hospital from January 2009 to March 2012. SLNB was performed by using methylene blue staining or the combination of methylene blue and 99Tcm-sulfur colloid tracing. Results The successful rate of SLN detection with methylene blue and 99Tcm-sulfur colloid tracing was 94.56% （139/147） in open operation group and 94.25% （82/87） in endoscopy group. The successful rate of SLN detection with methylene blue was 88.46% （138/156）in open operation group and 85.00% （17/20） in endoscopy group. The mean of detected SLN number with combined method or methylene blue was 1.90/1.98 in open operation group and 1.91/1.82 in endoscopy group respectively. SLN-positive rate was 22.30% （31/139） and 25.36% （35/138） in open operation group， and 19.51% （16/82） and 23.53% （4/17） in endoscopy group， respectively. The rate of subcutaneous effusion in endoscopy group was higher than that in open operation group （P=0.001）, but other postoperative complications presented no significant difference. Conclusions Endoscopic SLNB can obtain the similar safety and the clinical efficacy with traditional SLNB， but superior cosmetic effect. So it is worthy of clinical application in breast cancer.
ObjectiveTo review the recent studies about sentinel lymph node biopsy in breast cancer.MethodsThe literatures in recent years on the history, concept, technique and clinical application of sentinel lymph node biopsy were reviewed and summarized.ResultsThere was no unified method for sentinel lymph node biopsy. There was a wide range of detection rate and falsenegative rate.ConclusionProspective multicenter random clinical trials will help to evaluate the clinical application of sentinel lymph node biopsy.
ObjectiveTo study the detection methods of micrometastasis in sentinel lymph nodes (SLN) and their clinical significance. MethodsFifty women with breast carcinoma were included. SLN in fifty breast carcinoma was identified by using methylene blue staining to detect and remove them for routine hematoxylin and eosin stain and histological exam. All negative SLNs were examined by serial section (SS) with the section interval of 250 μm and HE stain for microscopic examination and immunohistochemical (IHC) exam was performed with CK19 monoclonal antibody. Then the above three detection methods were analyzed. All patients had axillary lymph node dissection (ALND)，and all none sentinel lymph nodes (NSLN) were examined by Hamp;E staining.ResultsThe SLNs were identified in 45 of 50 patients with a detection rate of 90%. Sixteen SLNs were found positive with routine histological exam, the positive detecting rate was 35.56%, while the other 29 negative SLNs were found 7 and 6 cases of micrometastasis using SS and IHC methods，therefore the positive detecting rate was increased by 15.55% and 13.33%, respectively.Conclusion SS and IHC methods could detect the micrometastasis in negative SLN with routinely histological exam, increasing the positive detecting rate and decreasing the false negative rate.
