2003 Fiscal Year Final Research Report Summary
Research for elucidation and clinical application of molecule mechanism of lymph duct proliferation and lymph node metastases
| Project/Area Number |
13671290
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Digestive surgery
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| Research Institution | KANAZAWA UNIVERSITY |
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Principal Investigator |
KITAGAWA Hirohisa Kanazawa University, University Hospital, Lecturer, 医学部附属病院, 助手 (80272970)
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| Co-Investigator(Kenkyū-buntansha) |
OHTA Tetsuo Kanazawa University, Graduate School of Medicine, assistant professor, 医学系研究科, 助教授 (40194170)
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| Project Period (FY) |
2001 – 2003
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| Keywords | Pancreas Cancer / Lymph node involvement / Lymph node surround SMA / Neural invasion / Lymph node dissention / Gall bladder cancer / Sentinel lymph node |
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| Research Abstract |
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.
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