Laparoscopic sentinel node biopsy in cervical cancer using a combined detection:: 5-years experience
Laparoscopic sentinel node biopsy in cervical cancer using a combined detection:: 5-years experience
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DOI：
10.1245/s10434-007-9424-6
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发表时间：
2007-08-01
影响因子：
3.7
通讯作者：
Barranger, Emmanuel
中科院分区：
文献类型：
--
作者：
Coutant, Charles;Morel, Olivier;Barranger, Emmanuel
背景：评估经5年经验的腹腔镜前哨淋巴结（SN）手术联合放射性同位素和专利蓝色标记治疗宫颈癌患者的可行性。方法：67例宫颈癌患者（中位年龄48.9岁）在放射性和专利蓝注射后，采用内窥镜伽玛探针行腹腔镜下SN手术。手术后，所有患者都进行了完整的腹腔镜盆腔/腹主动脉旁淋巴结切除术。结果：57例（85.1%）患者至少发现1例SN。按分期划分，早期宫颈癌SN检出率为91.2%，局部晚期宫颈癌SN检出率为78.5%。SN的平均数量为2.3例/例（范围1-5）。共移除129个SNs。14例（24.6%）患者中20例（15.5%）淋巴结转移。14例患者中有9例至少有一个大转移，3例H&S出现微转移，2例出现分离的单细胞。6例患者出现盆腔非sn受累，其中2例sn未受累。SNs假阴性率为12.5%（16例中2例）。这两名患者都患有局部晚期宫颈癌。结论：本研究证实了腹腔镜下放射胶体和专利蓝联合SN检测对早期宫颈癌患者盆腔淋巴结状态的准确评估。
Background: To evaluate the feasibility after 5 years experience of a laparoscopic sentinel node (SN) procedure with combined radioisotopic and patent blue labeling in patients with cervical cancer.Methods: Sixty-seven patients (median age 48.9 years) with cervical cancer underwent a laparoscopic SN procedure using an endoscopic gamma probe, after both radioactive and patent blue injections. After the procedure, all the patients underwent complete laparoscopic pelvic/para-aortic lymphadenectomy.Results: At least one SN was identified in 57 patients (85.1%). According to the Stage, the SN identification rate was 91.2% in early-stage cervical cancer and 78.5% in locally advanced cervical cancer. The mean number of SN was 2.3 per patient (range 1-5). A total of 129 SNs were removed. Lymph node metastasis involvement was identified in the 20 SNs (15.5%) from 14 patients (24.6%). Nine of the 14 patients had at least one macrometastases, three patients presented micrometastases in H&S, and two patients presented isolated single cells. Six patients presented a pelvic non-SN involvement including two patients whose SNs were uninvolved. The false-negative SNs rate was 12.5% (two patients out of 16). Both patients have locally advanced cervical cancer.Conclusion: This study confirms that laparoscopic SN detection with a combination of radiocolloid and patent blue is accurate in patients with early cervical cancer to assess pelvic lymph node status.