tumorsMalignant tumoursMalignant tumours2224-50572587-6813Rosoncoweb10.18027/2224-5057-2017-1-70-77tumors-331Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL REPORTSСторожевые лимфатические узлы при злокачественных новообразованияхSentinel lymph nodes in malignant tumorsЕРМАКОВА. В.ERMAKOVA. V.

к. м.н., научный сотрудник

MD, PhD, researcher

kamrey@rambler.ruСАРИБЕКЯНЭ. К.SARIBEKYANE. K.

д. м.н., ведущий научный сотрудник

MD, PhD, DSc, leading researcher

mammolog3@yandex.ruАБЛИЦОВАН. В.ABLITSOVAN. V.

к. м.н., научный сотрудник

MD, PhD, researcher

ab_natasha@mail.ruУСОВФ. Н.USOVF. N.

к. м.н., научный сотрудник

MD, PhD, researcher

fedus70@mail.ruМНИОИ им. П. А. Герцена – филиал ФГБУ «НМИРЦ» МЗ РФРоссияMNIOI P. A. HerzenRussian Federation201705072017017077Copyright © ЕРМАКОВ А.В., САРИБЕКЯН Э.К., АБЛИЦОВА Н.В., УСОВ Ф.Н., 20172017ЕРМАКОВ А.В., САРИБЕКЯН Э.К., АБЛИЦОВА Н.В., УСОВ Ф.Н.ERMAKOV A.V., SARIBEKYAN E.K., ABLITSOVA N.V., USOV F.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.malignanttumors.org/jour/article/view/331

В работе нашли отражения предпосылки возникновения концепции, история развития лимфографии, а также современное представление о состоянии дел в светеизучения концепции сторожевого лимфатического узла при злокачественных новообразованиях. Статус регионарного лимфатического узла имеет диагностическое значение для определения интенсивности злокачественного роста, так как метастазирование опухоли к регионарным лимфатическим узлам представляет собой первый шаг распространения опухоли большинства злокачественных новообразований. Комбинация и усовершенствование двух методик визуализации позволяет идентифицировать сторожевой лимфатический узел практически во всех случаях, в том числе при локализации опухоли в участках с неясным направлением лимфооттока. При отрицательных данных гистологического исследования  сторожевого лимфатического узла с большой степенью надежности можно говорить об отсутствии метастазов в других лимфатических узлах. Рутинное гистологическоеисследование лимфатического узла необходимо дополнять проведением  иммуногистохимического исследования. Лечебная лимфаденэктомия должны быть выполнена только при гистологическом и иммуно-гистохимическом обнаружении метастазов опухоли в удаленных лимфоузлах. При обнаружении микрометастазов в удаленном лимфатическом узле вопрос о преимуществе выполнения лимфаденэктомии требует дополнительного обсуждения.

The paper reflected the background of the concept, history of lymphography, as well as the current understanding the problem by studying of the concept of sentinel lymph nodes in  malignant tumors. As metastasis to regional lymph nodes is the first step in the spread of most malignant tumors the status of the regional lymph node has diagnostic value fordetermining the degree of malignancy. The combination of two imaging techniques of sentinel lymph node allows to identif y in almost cases, including in any tumor location even in uncer tain direction of lymph flow. In case of the negative sentinel lymphnode can be argued on the absence of metastases in other lymph nodes. Routine histological study of the lymph node should be completed by Immunohistochemistry analysis (Real-time PCR). Therapeutic lymph node dissection should be performed only by histological and Real-time PCR verification of tumor metastases in lymph nodes. In case of detection of micrometastases in lymph node remote question of the advantage of total lymph nodes dissection requires the fur ther discussion.

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The authors declare that there are no conflicts of interest present.