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[Key words] Gastric carcinoma; Sentinel lymph node; Micrometastasis; AE1/AE3; Immunohistochemistry

Abstract Objective: To evaluate sentinel lymph node biopsy (SLNB) technique in the application of early gastric cancer and sentinel lymph node (SLN) micrometastases and its clinical significance. Methods: 34 patients with early gastric cancer surgery in the methylene blue sentinel lymph node biopsy, pathology and postoperative routine HE monoclonal antibody AE1/AE3 cytokeratin immunohistochemistry (ELIVISION two-step) to check. Results: 34 cases in 33 cases detected in SLN, the detection rate was 97.1%. SLN status predicted by the lymph node metastasis of gastric accuracy rate of 93.9% (31/33), sensitivity was 88.9% (16/18), specificity of 100.0% (16/16), false negative rate was 11.1% ( 2 / 18). Immunohistochemistry and conventional HE method of SLN metastasis detection rate compared to the difference was statistically significant (P = 0.034), were detected by immunohistochemical method 12 / 8 cases of SLN micrometastases present phenomenon. Conclusion: SLN can more accurately reflect the status of lymph node metastasis in early gastric cancer, immunohistochemistry compared with conventional HE pathological examination is more sensitive, AE1/AE3 immunohistochemical method can improve the detection of SLN micrometastases, in determining the clinical stage, treatment and clinical significance of a positive prognosis.
1.1 clinical data taken from General Surgery, Affiliated Hospital of Nantong University, June 2005 - June 2007 line D2 or D3 resection of early gastric cancer 34 cases. Including 24 males and 10 females, aged 35 to 74 years, mean age 57.3 years. All patients underwent preoperative fiberoptic endoscopy and confirmed by pathology, did not receive chemotherapy and radiotherapy and did not had a history of abdominal surgery. 3 cases the tumor is located in U, M District 6 cases, L District 14 cases, LM District 8 cases, MU 3 cases. T1 in 14 cases, T2 in 20 cases. Adenocarcinoma in 3 cases,abercrombie fitch paris, moderately differentiated adenocarcinoma in 6 cases, in poorly differentiated adenocarcinoma - 6 cases of poorly differentiated adenocarcinoma in 19 cases.
sentinel lymph node (sentinel lymph node, SLN) is the local lymph nodes The first lymph node receiving lymphatic return is the first occurrence of lymph node metastasis. In this study, methylene blue in patients with early gastric cancer sentinel lymph node biopsy (sentinel lymph node biopsy, SLNB), combined with AE1/AE3 immunohistochemistry (ELIVISION two-step) to the SLN micrometastases detection, to investigate the In the treatment of early gastric cancer study the feasibility, accuracy and clinical significance.
Key words gastric cancer; sentinel lymph node; micrometastasis; AE1/AE3; immunohistochemistry

1.4 laboratory reagents used in experiments mouse anti-human cytokeratin monoclonal antibody AE1/AE3, PV-9000 kit (ELIVISION two-step) and DAB display agents were purchased from Beijing Zhongshan Golden Bridge Biotechnology Technology Co.,abercrombie pas cher, Ltd.. Jiang Su Jichuan methylene blue for the pharmaceutical production and other reagents were of Pathology, Affiliated Hospital of Nantong University offers.

Sentinel lymph node biopsy in early gastric cancer in the application and detection of micrometastases


Author: rank name Source: Date :04 -08-20 view: times Author: Jian-right, Mali Lin, Jian-Wei Zhu, SUN Jin Wei, in Jiawei, Yu-Quan Chen


[Abstract] Objective: To investigate the application of sentinel lymph node biopsy to early gastric carcinoma and clinical significance of sentinel lymph node micrometastasis detection. Methods: 34 patients with early gastric carcinoma intraoperatively underwent sentinel lymph node biopsy with methylene blue. All SLNs were studied with HE and keratin monoclonal antibody AE1/AE3 immunohistochemistry. Results: The stained SLNs could be identified in 33 (97.1%) of 34 patients. The accuracy of the SLN status in diagnosis of the lymph node status of the patients was 93.9%. Sensitivity was 88.9%. The specificity and false-negative rate were 100.0% and 11.1 %, respectively. The metastasis detection of SLN with immunohistochemistry had significant difference, compared with the routine pathologic examination (P = 0.034) .12 SLNs were found to have micrometastasis in 8 patients by immunohistochemical technology. Conclusions: SLN can explore the feature of lymph node metastasis in early gastric carcinoma, immunohistochemistry is more sensitive than HE in the exploration of lymph node metastasis. AE1/AE3 immunohistochemistry can improve the efficiency of detecting micrometastasis in SLNs, which has positive clinical significance for definition of clinical stage, treatment and prognosis in early gastric carcinoma.


1.2 sentinel lymph node localization and biopsy laparotomy,franklin marshall femme, confirmed that no violation of adjacent organs and distant metastases after the primary tumor in the surrounding select 4 points, 1 ml syringe with 1% methylene blue (methylene blue Jiang Su Jichuan pharmaceutical) Note on the serosal, each point of 0.2 ~ 0.5 ml,ralph lauren pas cher, total of about 0.8 ~ 2.0 ml. Press the injection site after injection of a moment, to prevent dye spill pollution perspective. 1 ~ 4 min to a few of you can see a blue-stained lymphatic vessels to the distance from the local tumor extension through the blue stained lymphatic vessels can be found in blue-stained lymph nodes. 1 to stain the first few lymph nodes as gastric cancer SLN, separate removal of gastric cancer underwent D2 or D3 resection (Figure 1). Routine HE pathology and mouse anti-human monoclonal antibody AE1/AE3 cytokeratin immunohistochemistry (ELIVISION two-step) to check SLN, in order to accurately determine the lymph node metastasis. Resection of gastric biopsy specimens with HE in order to determine the depth of tumor invasion.


1 Materials and Methods



1.6 statistical methods used Stata 10.0 software for statistical description, using χ2 test, with P <0.05 indicates comparison between groups was statistically significant difference.
1.3 sentinel lymph node biopsy results indicators with reference to the Japanese sub-station group developed gastric cancer Society 13th edition of The detection rate, accuracy, sensitivity and specificity of SLNB results such as gastric evaluation.
1.5 immunohistochemistry methods and results of operations to determine the working concentration of 1:100, AE1/AE3, according to PV-9000 kit experimental steps, with the medical microwave antigen retrieval, DAB stain, hematoxylin stained, dehydrated, transparent, and mounted. Using PBS solution instead of primary antibody as negative control, tumor tissue positive control. In immunohistochemical light microscopy within 24 h to complete the film-reading, photography. AE1/AE3 positive parts, mainly in the cytoplasm, and a brown granular staining intensity than non-specific background color of positive cells. Gastric cancer micrometastases showed scattered single and 2 to 3 and a number of aggregate into small lumps of cells in the lymphatic sinus, was a strong cytoplasm [2]. Graphic slice-free Xilang Jia pathological analysis system.

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