Статьи

Sentinel Lymph Node Biopsy (SLNB) versus Maruyama Computer Model in Gastric Cancer
Introduction

The extent of lymph node dissection in gastric cancer remains controversial. The Maruyama computer model and the sentinel lymph node biopsy (SLNB) are compared for their value to predict the nodal status and to warrant stage-adapted surgery.


Materials and Methods

34 Patients with stage I-IV gastric cancer underwent both staging procedures. For SLNB, 15 patients underwent endoscopic, peritumoral injection of 99mTc-colloid, and 19 patients injection of Patent blue V®.

All "hot" or blue SLNs were detected with hand-held gamma-probe (GammaFinder®, World of Medicine AG, Germany), were separately excised and histopatho - logically assessed.

If the sentinel lymph node (SLN) was negative after routine staining by H&E, it was processed completely and reanalyzed after immunohistochemistry. The probability of lymph-node metastases in different positions was calculated by the Maruyama computer model in all patients.




Results
Detection Sensitivity Specificity Positive/Predictive value Upstaging
SLNB (RCM+DM) 97% (33/34) 96% (22/23) 100% (10/10) 100% (22/22) 33% (5/15)
Maruyama Computer model - 96% (22/23) 20% (2/10) 73% (22/30) -

Conclusions

The clinical impact of the SLNB is higher than Maruyama computer model. The high specificity and a high negative and positive predictive value rendering the method SLNB as an useful indicator for individualized surgery.

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