Sentinel Node Biopsy in Gastric Cancer.
- Author:
Min Chan KIM
1
;
Ghap Joong JUNG
;
Seok Ryeol CHOI
;
Do Young KANG
;
Mee Sook ROH
;
Jin Sook JEONG
Author Information
1. Department of Surgery, Dong-A University College of Medicine, Busan, Korea. mckim@donga.ac.kr
- Publication Type:Original Article
- Keywords:
Sentinel lymph node biopsy;
Stomach neoplasm;
Radioisotope;
Lymphatic metastasis
- MeSH:
Biopsy*;
Gamma Cameras;
Gastrectomy;
Head;
Humans;
Immunohistochemistry;
Keratins;
Lymph Nodes;
Lymphatic Metastasis;
Lymphoscintigraphy;
Neoplasm Metastasis;
Neoplasm Micrometastasis;
Paraffin;
Sensitivity and Specificity;
Sentinel Lymph Node Biopsy;
Stomach Neoplasms*
- From:Journal of the Korean Surgical Society
2003;65(3):223-227
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: The Sentinel lymph node (SLN) is the first draining node from the primary lesions, and is the first site of lymph node metastasis in malignancies. The aim of this study was to determine the feasibility of a SLN biopsy in patients with gastric cancer to assess the regional lymph node status. METHODS: A SLN biopsy was performed in 46 consecutive gastric cancer patients, with preoperative imaging stages of T1/T2, N0 and M0. Three hours prior to each operation, a (99m)Tc tin-colloid (2.0 ml, 1.0 mCi) was endoscopically injected into the gastric submucosa around the primary tumor. Subsequently, serial lymphoscintigraphy was performed using a dual head gamma camera. After the SLN biopsy had been performed using a gamma probe, the patients underwent a radical gastrectomy (D2 or D2+ alpha). The SLNs were cut and immediately frozen-sectioned. A paraffin block was then produced for permanent hematoxylin-eosin staining and immunohistochemistry (IHC). RESULTS: SLNs were successfully identified in 43 of the 46 patients (success rate, 93.5%), at an average of 2 (range, 1~8) per patient. The positive and negative predictive values, sensitivity and specificity of the SLN biopsy were 100 (11/11), 93.8 (30/32), 84.6% (11/13) and 100% (30/30), respectively. SLNs were located at the level I, I+II and II lymph nodes in 38 (88.4%), 2 (4.7%) and 3 (7.0%), respectively. No micrometastases of the SLNs was found on the IHC for cytokeratin. CONCLUSION: A sentinel lymph node (SLN) biopsy, using a radioisotope, in patients with gastric cancer is a technically feasible and accurate technique, and is a minimally invasive approach for assessing the nodal status in patients.
