目的

探讨定位结直肠癌（CRC）前哨淋巴结（SLN）方法以及临床应用价值。

方法

运用体内或体外注射亚甲蓝定位105例SLN，采用多层面HE染色检测SLN中转移癌,探讨对CRC分期的影响。

结果

体内定位SLN 44例，成功41例，SLN平均数目为1.37枚/例，体外定位61例，成功58例，SLN平均数目为1.59枚/例（P=0.1710）；SLN位置分布无差别（P=0.3450）。105例病人总淋巴结数目为1944枚，平均为18.51枚/例，总SLN定位成功率为95.24%，平均SLN为1.49枚/例。常规病理检测SLN 转移阴性55例，其中行多层面HE染色发现微转移6例，提高7.40%淋巴结转移阴性病人的病理分期。

结论

结直肠癌体内、体外SLN定位均可获得成功，SLN多层面HE染色检测有助于提高早期结直肠癌的病理分期。

Objective

To investigate difference of mapping sentinal lymph node (SLN) in vivo and in vitro and SLN's value in colorectal cancer (CRC) staging.

Methods

One hundred and five patients treated by surgery for CRC were admitted in this protocol. A subserosal peritumoral injection of methylene blue was performed 20 min before or after completing the colorectal resection.The SLN were harvested and employed for H&E staining to identify micrometastasis.

Results

There were no difference between in vivo and in vitro mapping of SLN according to location and number of SLN. The total number of lymph nodes were 1944 ( 18.51 per patient). In 95.24%cases, SLN were identified perfectly and presented a mean of 1.49. Fifty five patients were negative for lymph node metastasis, while serial cuts HE staining showed micrometastasis in 6 cases. The upstaging rate from Dukes' A or B to C was 7.40%.

Conclusion

SLN mapping of CRC can be performed successfully notonly in vivo but also ex vivo,SLN serial cut HE staining may be helpful for upstaging of CRC.