What Is the Sentinel Lymph Node?

Sentinel lymph nodes are special lymph nodes in the lymph nodes in the drainage area of the primary tumor, and are the first batch of lymph nodes that must undergo lymph node metastasis. Sentinel lymph nodes, as a barrier to prevent tumor cells from spreading from the lymphatic tract, have been valued for its clinical significance.

Sentinel lymph node

Sentinel lymph nodes are special lymph nodes in the lymph nodes in the drainage area of the primary tumor.

Sentinel lymph nodes, as a barrier to prevent tumor cells from spreading from the lymphatic tract, have been valued for its clinical significance. ^[1]

In the 1990s, sentinel lymph node biopsy for breast cancer became a milestone in the field of breast surgery. The application of this technique allows axillary lymph node negative breast cancer patients to avoid axillary lymph node dissection. At the European Oncology Conference held in Lisbon, Portugal, research reports on sentinel lymph nodes were not limited to breast cancer, and radical surgery to expand the scope of resection of other early malignancies is also being challenged. Further narrowing the scope of surgery, reducing the trauma caused to patients, and the development of cancer treatment that improves the quality of life of patients is receiving attention.

For example, sentinel lymph nodes are the first stop of lymphatic metastasis in breast cancer. During breast mastectomy and sentinel lymph node biopsy, a small incision is made in the axilla and the sentinel lymph nodes are accurately removed and biopsied. If the pathology is negative, the operation is terminated. Positive for axillary lymph node dissection. Therefore, finding the sentinel lymph nodes has become an important part of the operation.

The figure on the right shows the relationship between sentinel lymph nodes and breast tumors. There are currently only three ways to detect sentinel nodes in the world:

1. Blue dye method : This method is more traditional. The use of blue dyes such as US blue is not effective and requires a long learning curve for physicians.

2. Nuclide detection method : Because it involves radioactive elements, it has a certain radiation effect on the human body, and at the same time it will cause pollution to the environment. It is also troublesome to use.

3. Fluorescence detection method : This is the latest fast and safe detection method. Using Photodynamic Eye (PDE) to view the ICG tracer, you can quickly find the sentinel lymph nodes and image them on the display. The disadvantage is that the equipment system is more expensive. Peking University People's Hospital has also recently started using this device, and there are many academic papers on this method internationally.

With the continuous improvement of the quality of surgery, the requirements for surgery are getting higher and higher, and the degree of fineness and micro-injury of the operation are getting more and more attention. Sentinel lymph node localization and biopsy can effectively avoid the trauma caused by axillary lymph node dissection, thus avoiding postoperative injuries.

Fluorescent navigation image during surgery: