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Comparative Study
. 2006 Nov;88(7):632-8.
doi: 10.1308/003588406X149200.

Lymphoscintigraphy in detection of the regional lymph node involvement in gastric cancer

M Mahir Ozmen  1 , Baris Zulfikaroglu, N Ozlem Kucuk, Necdet Ozalp, Gulseren Aras, Tankut Koseoglu, Mahmut Koç
Affiliations
Comparative Study

Lymphoscintigraphy in detection of the regional lymph node involvement in gastric cancer

M Mahir Ozmen et al. Ann R Coll Surg Engl. 2006 Nov.

Abstract

Introduction: Involvement of regional lymph node is a critical sign in prognosis of gastric cancer. Radiological techniques are commonly used to evaluate the extension of gastric cancer. But their sensitivity and specificity are low especially in the early stage. Our aim was to assess the value of gastric lymphoscintigraphy in identifying regional lymph node involvement in patients with gastric cancer, as compared to the abdominal ultrasonography, computed tomography and postoperative histopathological evaluation.

Patients and methods: 50 patients (12 females) with a median age of 61 years (range, 35-73 years) were included in the study. Pre-operative staging in all cases included upper gastrointestinal endoscopy and biopsy, followed by ultrasound, computed tomography and lymphoscintigraphy. 148 MBq Technetium-99m lymphoscint was injected around the tumour during endoscopy and immediately after injection, anterior, lateral and posterior images were taken in 5-min intervals using a gamma camera. Findings were compared to the findings of other tests. The sensitivity, specificity, positive predictive value, and negative predictive value of each test were calculated and compared.

Results: Histologically, 68% of cases (34/50) had metastasis in regional lymph nodes and all cases were accurately diagnosed by lymphoscintigraphy. Lymphoscintigraphy was significantly more sensitive for detecting lymph node involvement (P < 0.01). Both abdominal ultrasonography and CT had very low sensitivity in identifying lymph nodes.

Conclusions: Lymphoscintigraphy is a promising test in the identification of regional lymph nodes pre-operatively in patients with gastric cancer. It might help the surgeon to plan the extent of dissection before surgery which may decrease postoperative complications related to unnecessary extensive lymph node dissection.

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Figures

Figure 1
Figure 1
Lymphoscintigram of patient with T2 tumour and lymph node involvement. Abdominal lymph nodes in midline and periportal area.
Figure 2
Figure 2
Para-oesophageal, perigastric and omental lymph nodes in the mid-abdomen.
Figure 3
Figure 3
Lymph nodes in para-oesophageal and periportal area.
Figure 4
Figure 4
Lymph nodes around antral area.
See this image and copyright information in PMC

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References

    1. Harrison JD, Fielding JW. Prognostic factors for gastric cancer influencing clinical practice. World J Surg. 1995;19:496–500. - PubMed
    1. Akoh JA, Macintyre IM. Improving survival in gastric cancer: review of 5-year survival rates in English language publications from 1970. Br J Surg. 1992;79:293–9. - PubMed
    1. Allum WH, Powell DJ, McConkey CC. Gastric cancer: a 25-year review. Br J Surg. 1989;76:535–40. - PubMed
    1. Maruyama K. The most important prognostic factors for gastric cancer patients. Scand J Gastroenterol. 1987;22:63–8.
    1. Soreide JA, van Heerden JA, Burgart LJ, Donohue JH, Sarr MG, Ilstrup DM. Surgical aspects of patients with adenocarcinoma of the stomach operated on for cure. Arch Surg. 1996;131:481–6. - PubMed