Two-site secondary sentinel lymph node tracing practice in patients with advanced gastric cancer / 中华普通外科杂志

ABSTRACT

Objective:To evaluate a two-site secondary sentinel lymph node(SSLN) tracing technology in advanced gastric cancer and its clinical significance.Methods:From Jan 2016 to Dec 2018, 88 advanced distal gastric cancer patients with preoperative confirmed group 5 and group 6 lymph node metastasis were included into a SSLN tracing with nano carbon during the operations to observe imaging range and features. Results were judged by a biopsy.The relationship between SSLN metastasis and parameters such as size, infitrating depth and histological category was evaluated, and compare with the result of one-site SSLN tracing.Results:SSLNs were found in 79 out of 88 patients (90%). Pathological and immunohistochemical examination found SSLNs metastases in 66 cases with a positive rate of 84%, and 139 SSLNs metastases in 164 SSLNs(85%). SSLN positivity was higher in patients with tumor diameter of ≥5 cm, poorer differentiation and deeper infiltration, though not reaching statistical differece, P>0.05. Compared with the result of previously reported one-site SSLN, two site SSLNs detection rate (90% vs. 78%) and SSLNs positive rate (85% vs. 76%) were higher, (χ 2=4.450, 4.078, all P< 0.05); SSLNs positive rate of cases (84% vs. 80%) was higher, the difference was not statistically significant (χ 2=0.335, P>0.05). Conclusion:The application of two-sites SSLN tracing technology can find more metastatic SSLNs in advanced gastric cancer.