THE BIOLOGICAL CONCEPTUALIZATION OF THE SENTINEL LYMPH NODE (LITERATURE REVIEW)

Abstract

The paper reflects the current understanding of the concept of sentinel lymph nodes in malignant tumors. The status of the ly mph nodes is the most important predictor of survival and proper treatment depends on the number of involved nodes. The identification of the sentinel lymph node is the radiological method, both alone and in combination with the blue-dye. Applied during surgery lymphography technique is designed to identify the sentinel lymph node. In order to achieve appropriate accuracy of the method are required a special selection of patients, effective markers and some surgical experience. The key is a multidisciplinary approach with the involvement of a radiologist and pathologist. The concept of sentinel lymph node does not be used in all cases for predicting metastasis process. Region-specific modification and correction are required to optimize the use of SLN-imaging, especially for elderly patients with early-stage cancer. Using the method of identification of sentinel lymph nodes seems important in terms of studying the individual characteristics of lymph from different segments of the body, which may be different directions. SLN-biopsy is extremely helpful to find metastasis in node in the very early stages of cancer. Prior to the development of metastasis, VEGF-A induces a lymphangiogenesis in the sentinel lymph node, which gives grounds to assume that the primary tumor can prepare future path of metastasis, producing factors lymphangiogenesis, which provide efficient transport of tumor cells in the sentinel lymph node. This mechanism is to stimulate lymphangiogenesis in the sentinel lymph node, facilitating metastasis, represents a new therapeutic target for preventing metastasis. In elderly patients with malignant tumors, histologic heterogeneity replaces homogeneous morphology with numerous or large secondary follicles in welldeveloped cortex. Histological heterogeneity can modulate the movement of cancer cells with a high probability to the lymph nodes, having the age architectural changes. Lymphangiogenesis and increased lymph flow through the tumor draining regional lymph node metastasis can strengthen the lymphatic tubules. Descriptions morphological rearrangements in the regional lymph nodes in the malignant growth are similar in nature and vary in severity depending on the changes in the tumor type, location, and time of development.