Research for elucidation and clinical application of molecule mechanism of lymph duct proliferation and lymph node metastases

淋巴管增殖及淋巴结转移分子机制阐明及临床应用研究

基本信息

批准号：
13671290
负责人：
KITAGAWA Hirohisa
金额：
$ 1.15万
依托单位：
KANAZAWA UNIVERSITY
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2001
资助国家：
日本
起止时间：
2001 至 2003
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-13671290/
关键词：
Pancreas Cancer Lymph node involvement Lymph node surround SMA Neural invasion Lymph node dissention Gall bladder cancer Sentinel lymph node SMA周囲リンパ節センチネルリンパ節リンパ節微小転移郭清 VEGF-C 大動脈周囲リンパ節

项目摘要

We tried the introduction of sentinel node concept for lymph node dissection in the case of the pancreas and biliary tract canoer in proper quantities. lymphatic flow was observed by using Patent blue in surgical operation, and serched a sentinel lymph node (SLN). Micrometastasis of a lymph node was investigated by using the cytokeratin-19, and it groped for the way that dissection area of each case was decided.Pancreas head cancer : NO.13 was a sentinel node(SLN). Lymphatic flow way spread out from there to the para-aortic resion surroundings of the left renal vein. When the status of lymph node involvement of the past case were examined together, it could think that you had only to decide the adaptation and area of NO.16 dissection by the existence of the metastasis of SLN of NO.13. If SLN metastasis is negative, a area of dissection should limit it to 16a2b1int, but should expand it to int, pre latero of 16a1a2b1 if SLN metastasis is positive.Gallbladder cancer : No.12bc was SLN. It was observed lymphatic flow passed though No.13a, No.8 from No.12bc, and spreading through No.16a2b1int surroundings of the left renal vein. IfSLN of No.12bc includes metastasis, you should dissectin No.13a, 8 and should dissect in No.16 if furthermore, there is metastasis in No.13a, 8.However, it was difficult to detect lymphatic flow to SMA direction by this method. We developed the operative method which excised SMA and caput pancreatic en bloc. I did it in 11 examples by the present and studied development to circulation/a nervous system of SMA circumference. We made a complete holoblastic cleavage specimen of caput pancreatic partincluding SMA removed surgically by this operation methed in a 6case. We searched microscopically what kind of development pattern pancreatic cancer spread through SMA circumference.

我们尝试在适当数量的胰腺和胆道癌的情况下引入前哨淋巴结概念进行淋巴结清扫。手术中使用专利蓝观察淋巴流向，并检查前哨淋巴结（SLN）。使用细胞角蛋白-19研究淋巴结的微转移，摸索每个病例的解剖区域的确定方法。胰头癌：NO.13是前哨淋巴结(SLN)。淋巴管由此向外扩散至左肾静脉主动脉旁病变周围。结合既往病例的淋巴结受累情况，可以认为只需根据NO.13的SLN是否有转移来决定NO.16清扫的适应范围和范围即可。如果SLN转移呈阴性，则解剖区域应将其限制在16a2b1int内，但如果SLN转移呈阳性，则应将其扩大至16a1a2b1的前侧。胆囊癌：No.12bc为SLN。观察到淋巴液流从No.12bc开始经过No.13a、No.8，并扩散至No.16a2b1int左肾静脉周围。如果No.12bc的SLN有转移，则应解剖No.13a、8，如果No.13a、8有转移，则应解剖No.16。但是，通过此方法很难检测到SMA方向的淋巴流向方法。我们开发了将SMA和头状胰腺整体切除的手术方法。到目前为止，在11例中进行，研究了SMA周围的循环/神经系统的发育。我们用此手术方法制作了6例完整的胰头部分全裂标本，其中包括手术切除的SMA。我们通过显微镜研究了胰腺癌在 SMA 周围扩散的发展模式。