THE DISTRIBUTION AND CLINICAL SIGNIFICANCE OF SENTINEL LYMPH NODE DEMONSTRATED BY GASTRIC CARCINOMAS WITH SOLITARY LYMPH NODE METASTASIS / 解放军医学杂志

ABSTRACT

To investigate the distribution and clinical significance of sentinel lymph node(SLN) in gastric cancer, and to provide novel methods for further prospective study, the location of the first node with metastasis, and the correlation between it and primary tumor site were studied in this paper by retrospectively examining 75 cases of gastric cancer with only one positive node demonstrated during operation and pathologic examination. This positive node was regarded as SLN. The results revealed that the solitary metastatic nodes were found in the nearest perigastric nodal area in 55% of cases, in a fairly remote perigastric area in 28% of them, and in the N2-N3 area without N1 involvement in 17%. Among 13 cases of gastric carcinoma with “leaping” metartasis, the depth of invasion was mucosal in one patient, SM, SS or Se in other 12 cases. We conclude that the location of SLN in gastric cancer is random and multidirectional, and the rate of “leaping” metastasis is much higher than expected ,which indicates that the examination of the nodal area close to the primary tumor may not be a reliable method to detect SLN in gastric carcinoma. Although the feasibility of SLN concept in gastric cancer cannot be questioned with these findings, novel techniques combining the dye directed and radioguided methods need to be developed.