Study of lymphatic mapping and sentinel node identification in early stage cervical cancer
Study of lymphatic mapping and sentinel node identification in early stage cervical cancer
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DOI：
10.1016/j.ygyno.2005.04.016
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发表时间：
2005-08-01
影响因子：
4.7
通讯作者：
Hrehorcak, M
中科院分区：
文献类型：
--
作者：
Rob, L;Strnad, P;Hrehorcak, M
Objective.本研究旨在比较蓝色染料法和（99 m）Tc法对前哨淋巴结（SLN）的鉴别，评价SLN的检出率、特异性检出率（SSDR）、SLN的分布、阳性SLN的分布以及两种方法的假阴性率。从2000年2月至2004年9月，我们纳入了183例早期宫颈癌患者。本文对两种SLN的检测方法（专利蓝法100例，专利蓝-Tc-99 m法83例）进行了评价。我们根据肿瘤的大小和手术方法的类型（腹腔镜，开腹手术）对该组进行分层。两种方法联合应用（Tc +蓝色染料）SSDR = 93%，而仅用蓝色染料SSDR = 71%，SLN的识别率提高（OR：5.76，CI 95%-2.9 - 11.4，< 0.0001）。462个SLN的分布：髂外动、静脉45.0%，闭孔上42.6%，分叉和髂总动、静脉4.8%，骶前4.6%，外侧子宫旁组织内侧3%。44例SLN阳性标本的分布：髂外动、静脉约占38.6%，闭孔上占45.5%，髂总、分叉动、静脉占6.8%，骶前占4.5%，外侧旁组织内侧占4.5%。1例假阴性SN位于骶前区。99 mTc与蓝色染料联合检测SLN的结果明显优于单独使用蓝色染料。我们的研究证明了该方法的高灵敏度，特异性和低假阴性。(c)2005年爱思唯尔公司All rights reserved.
Objective. The aim of our study was to compare the identification of sentinel lymph nodes (SLN) by blue dye and (99m) Tc; to evaluate detection rate per patient and specific side detection rate (SSDR) of SLN, distribution of SLN and distribution of positive SLN and false negative rate of the methods.Patients and methods. From February 2000 until September 2004, we included 183 women with early stage cervical carcinoma. We evaluated two methods of detection of SLN (100 cases by Patent blue, 83 cases by Patent blue with Tc-99m). We stratified the group upon the size of the tumor and upon the type of surgical method (laparoscopy, laparotomy).Results. SLN identification increased in cases when we used combination of both methods (Tc + blue dye) SSDR = 93% versus the use of blue dye only SSDR = 71% (OR:5,76, Cl 95% -2.9 -11.4, < 0.0001). Distribution of 462 SLN-45.0% external iliac artery and vein, 42.6% supraobturator, 4.8 bifurcation and common illiac artery and vein, 4.6% praesacral, 3% medial part of lateral parametrium. Distribution of 44 positive SLN-approxirnately 38.6% external illiac artery and vein, 45.5% supraobturator, 6.8% bifurcation and common illiac artery and vein, 4.5% praesacral, 4.5% medial part of lateral parametrium. One false negative SN was in presacral area.Conclusion. Detection of SLN by combination of Tc-99m and blue dye was statistically significantly better than blue dye alone. Our study documents high sensitivity, specificity and low false negativity of the method. (c) 2005 Elsevier Inc. All rights reserved.