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The secret of cancer spread: How are lymph nodes the first target?
The spread of cancer has always been an important topic of research in the medical community. In these studies, the role of lymph nodes is particularly critical. According to speculation in the medical community, lymph nodes are not only filters for lymph fluid, but also the first target for cancer cells to metastasize. This article will delve into the importance of lymph nodes, especially sentinel lymph nodes, in the spread of cancer, as well as the clinical significance and challenges of performing sentinel lymph node dissection (SLNB).
The definition and physiological role of sentinel lymph nodes
A sentinel node is the first lymph node or group of lymph nodes that drains a tumor. When cancer has spread, sentinel lymph nodes are often the first place cancer cells invade. When cancer cells break away from a tumor, they spread through the nearest lymph nodes.
If the sentinel lymph nodes do not contain cancer cells, it is critical that the cancer has not spread to other parts of the body.
How to examine sentinel lymph nodes
The purpose of sentinel lymph node surgery is to check whether the cancer has spread to the first draining lymph node. This surgery involves a variety of examination techniques, such as:
- Preoperative planar lymphatic scan
- Intraoperative blue dye detection
- Intraoperative gamma probe detection
Before surgery, doctors inject a small amount of radioactive material into the tissue near the tumor and then scan the lymph nodes to identify which sentinel lymph nodes need to be examined. If a lymph node shows color or detects radioactive material, it will be removed and sent for pathology examination.
Clinical advantages and research aspects
Clinical advantages of sentinel lymph node dissection include reducing unnecessary lymph node dissection, thereby reducing the risk of lymphedema, a common complication after lymph node dissection. Compared with traditional complete lymph node dissection, this technique focuses on the lymph nodes most likely to contain metastasis.
Many clinical studies have shown that this approach can increase the detection of subtle metastases, thereby helping to change cancer staging and treatment.
Challenges and shortcomings
Although sentinel lymph node technology brings many benefits, it also has some disadvantages. For some patients, the technology may not be able to detect all cancer cells, leading to false negatives. In addition, some studies have shown that patients who undergo complete lymphadenectomy may not have better survival rates than those who do not.
Historical background
The concept of sentinel lymph nodes was first proposed by Gould et al. in 1960. Later, this technology was widely used in the treatment of different cancer types. For example, stopping tumors at an early stage or reducing the scope of metastasis has been proven to significantly improve patient outcomes.
Future Outlook
Although sentinel lymph node technology has achieved certain results so far, related research needs to continue in the future. Whether it is improving detection technology or further understanding of tumor biology and metastasis mechanisms, these are the directions for future research.
In the realistic journey of cancer, the role of lymph nodes seems to be becoming more and more important. Can we learn more about this to help improve cancer diagnosis and treatment?
