Sentinel node identification in cervical cancer patients undergoing transperitoneal radical hysterectomy: a study of 100 cases
Sentinel node identification in cervical cancer patients undergoing transperitoneal radical hysterectomy: a study of 100 cases
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DOI：
10.1136/ijgc-00009577-200603000-00030
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发表时间：
2002-03
期刊：
影响因子：
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通讯作者：
D. Wydra;S. Sawicki;S. Wojtylak;T. Bandurski;J. Emerich
中科院分区：
文献类型：
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作者：
D. Wydra;S. Sawicki;S. Wojtylak;T. Bandurski;J. Emerich
我们在100例接受根治性子宫切除术和盆腔淋巴结切除术的早期宫颈癌患者（58例FIGO分期IB 1，18例IB 2，24例IIA）中，研究了使用放射性同位素淋巴映射与锝-99 m标记的纳米胶体和蓝色染料注射识别前哨淋巴结（SN）的可行性。84%的患者单侧至少有一个SN，66%的患者双侧至少有一个SN。根据分期的前哨检测率如下：IB 1、IB 2和IIA中的96.6%、66.7%和62.5%，其中一侧至少有一个SN; IB 1、IB 2和IIA中的86.2%、38.9%和37.5%，其中两侧至少有一个SN。与肿瘤≤2 cm的患者（SN的96%）相比，肿瘤>2 cm的患者（SN的54%）成功识别至少一个SN的可能性较低。在15/22例患者中，SN是肿瘤阳性的唯一淋巴结。SN程序的假阴性率为3%（3/100）。在所有假阴性的SN中，原发性颈部肿瘤大于2cm，并有峡部浸润。SN检测的敏感性为86.4%（19/22），特异性为100%（66/66），阴性预测值为95.5%（63/68）。前哨淋巴结的检出率相对较高，取决于肿瘤的大小和FIGO分期。
We investigated the feasibility of sentinel lymph node (SN) identification using radioisotopic lymphatic mapping with technetium-99m-labeled nanocolloid and blue-dye injection in 100 patients with early cervical cancer (FIGO stage IB1 in 58, IB2 in 18, and IIA in 24) undergoing radical hysterectomy with pelvic lymphadenectomy. At least one SN was found in 84% on one side and in 66% on both sides. The sentinel detection rates according to the stages were as follows: 96.6% in IB1, 66.7% in IB2, and 62.5% in IIA with at least one SN on one side, and 86.2% in IB1, 38.9% in IB2, and 37.5% in IIA with at least one SN on both sides. Successful identification of at least one SN was less likely in patients with tumors >2 cm (54% of SN) compared with those with tumors ≤2 cm (96% of SN). In 15/22 patients, the SNs were the only lymph nodes that were tumor positive. The false-negative rate for the SN procedure was 3% (3/100). In all false-negative SNs, the primary cervical tumor was above 2 cm and there was an isthmus infiltration. SN detection had 86.4% sensitivity (19/22), 100% specificity (66/66), and 95.5% negative predictive value (63/68). The sentinel node detection rate is relatively high and depends on the tumor size and FIGO stage.