Amethyleneblue-assistedtechniqueforharvestinglymphnodesafterradicalsurgeryforgastriccancer:aprospective,randomized,controlledstudy.

亚甲蓝辅助染色技术应用于胃癌根治术后淋巴结的摘除：一项前瞻性随机对照研究

AoyamaT,FujikawaH,ChoH,OgataT,ShiraiJ,HayashiT,RinoY,MasudaM,ObaMS,MoritaS,YoshikawaT

Americanjournalofsurgicalpathology；Volume39,February,Issue2,pp.-:-73

李国霞医院病理科

华夏病理学网

胃切除术后淋巴结(LNs)摘除对胃癌准确分期至关重要。本试验随机性评估传统方法和亚甲蓝辅助染色方法对临床淋巴结摘除的效率和质量。病例筛选主要标准如下：（1）组织学证实为胃腺癌，（2）临床分期为I-III期，（3）行胃切除术加D1+或D2淋巴结清扫术，术后达到RO级切除。主要观察终点是每分钟摘除淋巴结做病理检查的数目比例作为效率测定指标，次要观察终点是摘除淋巴结的数目作为质量测定指标。年8月到年12月期间共60名患者，接受传统方法摘除淋巴结的有29名，接受亚甲蓝辅助染色方法的有31名。两组间基线人口统计学指标基本均衡。采用传统方法摘除淋巴结的数目为33.6±11.9（平均值±标准差），采用亚甲蓝染色方法摘除淋巴结的数目为43.4±13.9（P=0.）。传统方法摘除淋巴结数目比例为1.12±0.46LNs/分，亚甲蓝染色方法摘除淋巴结数目比例为1.49±0.59LNs/分(P=0.)。亚组分析显示亚甲蓝辅助染色方法的质量和效率均优于传统方法。因其既高质又高效，应推荐亚甲蓝染色技术用于胃癌手术淋巴结摘除。

Harvestinglymphnodes(LNs)aftergastrectomyisessentialforaccuratestaging.Thistrialevaluatedtheefficiencyandqualityofaconventionalmethodandamethyleneblue-assistedmethodinarandomizedmanner.Thekeyeligibilitycriteriawereasfollows:(i)histologicallyprovenadenocarcinomaofthestomach;(ii)clinicalstageI-III;(iii)R0resectionplannedbygastrectomywithD1+orD2lymphadenectomy.TheprimaryendpointwastheratioofthepathologicnumberofharvestedLNspertime(minutes)asanefficacymeasure.ThesecondaryendpointwasthenumberofharvestedLNs,asaqualitymeasure.BetweenAugustandDecember,60patientswereassignedtoundergotreatmentusingtheconventionalmethod(n=29)andthemethylenebluedyemethod(n=31).Thebaselinedemographicsweremostlywellbalancedbetweenthe2groups.ThenumberofharvestedLNs(mean±SD)was33.6±11.9intheconventionalarmand43.4±13.9inthemethylenebluearm(P=0.).TheratioofthenumberoftheharvestedLNspertimewas1.12±0.46LNs/minintheconventionalarmand1.49±0.59LNs/mininthemethylenebluearm(P=0.).Inthesubgroupanalyses,thequalityandefficacywerebothsuperiorforthemethylenebluedyemethod







































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