| Background and Objective:Sentinel lymph node (SLN) is the lymph node that is first involed with metastasis. It usually includes one or several nodes. The conception and detection methods of SLN were widely used in the study of a variety of cancers such as murine melanoma, breast cancer, gastric cancer, thyrophyma and cervicel cancer. Especially in the study of breast cancer, the researchers have made great progress.At present, the study of sentienl lymph node location biopsy of colorectal carcinoma is still in the preliminary stage, and there are many disputions. This study investigated the feasibility of in-vivo biopsy operation of sentinel lymph node in colorectal carcinoma, and evaluated the efficiency of SLN micro-matastsis examination in colorectal cancer pathological staging and the prediction of regional lymph node's transfering states.Method: (1) Location of SLN in colorectal carcinoma SLN location technology was used to locate the SLN in 64 cases of colorectal carcinoma patients hospitalized from september 2008 to february 2010 in the first affiliated hospital of Gannan medical college. (2)Study of the expression of thymidylnate synthase (TS) in colorectal carcinoma P-V method of immunohistochemistry was used to detect the expression of TS in 64 colorectal carcinoma tissue samples and 26 tissues samples adjacent to colorectal carcinoma. (3)Study of the expression of TS in SLN of colorectal carcinoma P-V method of immunohistochemistry,RT-PCR and HE staining were used to detect the expression of TS in SLN of 61 samples where SLN was located successfully.Results:(1) 52 cases and 99 sentinel lymph nodes were detected in 64 patients. The detection rate is 81.3%. The percentage of SLNs in all nodes is 13.8%, with each patient carries 1.9 nodes on average. (2)28 cases SLN were positive for HE staining. The metastasis rate is 53.84%. The sensitivity, specificity and accuracy is 77.8%, 66.7% and 76.9%, respectively. (3)The expression rate of TS in colorectal carcinoma was 56.2%(36/64), significantly higher than that (23.1%, 6/26) in tissues adjacent to colorectal carcinoma (P<0.05). The positive rate of TS protein in colorectal carcinoma is higher with decrease of tumor differentiation. TS expression in pancreatic carcinoma is not correlated with age, gender, tumor location and growth pattern. (4)P-V method of immunohistochemistry and RT-PCR were used in 24 cases and 47 sentinel lymph nodes with negative HE staining. 14cases are positive for TS expression. The positive rate was 58.33% (14/24). (5)When using micrometastasis detection of SLN in colorectal carcinoma, the sensitivity, specificity and accuracy is 95.4%, 80.0% and 96.2%, respectively, much higher than that of simply HE staining(P<0.05).Conclusions: (1) The method of blue staining tecnology to detect SLN in colorectal carcinoma is feasible, and the pathological state of SLN could represent that of metastasis of regional lymph nodes. (2)The expression of TS in colorectal carcinoma is significantly higher than that in tissues adjacent to colorectal carcinoma. Positive rate of TS protein in colorectal carcinoma became higher with decrease of tumor differentiation. (3)Detection of TS could improve the detection rate of colorectal carcinoma metastasis in lymph node, and could help to predict the metastasis status of regional lymph nodes.
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