Lymphatic mapping and detection of sentinel nodes in patients with bladder cancer
Lymphatic mapping and detection of sentinel nodes in patients with bladder cancer
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DOI：
10.1016/s0022-5347(05)65842-9
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发表时间：
2001-09-01
影响因子：
6.6
通讯作者：
Thörn, M
中科院分区：
文献类型：
--
作者：
Sherif, A;De la Torre, M;Thörn, M
目的：我们研究了检测膀胱癌患者前哨淋巴结的可能性，以及所识别的前哨淋巴结的组织病理学状态是否反映了淋巴野的组织病理学状态。材料和方法：共有 13 名符合根治性膀胱切除术标准的膀胱癌患者，在肿瘤周围膀胱内注射放射性示踪剂和蓝色染料标记物，然后进行淋巴闪烁扫描，以可视化淋巴引流并检测前哨淋巴结。前哨淋巴结在术前通过蓝色和增加的放射性进行识别，并与其他常规切除的淋巴结进行组织病理学比较。结果：85%（13 名患者中的 11 名）检测到前哨淋巴结。有4例患者的前哨淋巴结含有肿瘤细胞，且每次仅在检测到的前哨淋巴结内看到转移。没有假阴性前哨淋巴结。转移性前哨淋巴结中有3个位于闭孔窝正常切除淋巴结之外。结论：膀胱癌患者中可检出前哨淋巴结。所识别的前哨淋巴结的组织病理学状态对于所有其他切除的淋巴结具有诊断意义。前哨淋巴结通常位于闭孔淋巴野之外，通常在膀胱癌术前分期期间进行检查。
Purpose: We examined the possibility for detecting sentinel nodes in patients with bladder cancer and whether the histopathological status of identified sentinel nodes reflected that of the lymphatic field.Materials and Methods: A total of 13 patients with bladder cancer who met the criteria qualifying them for radical cystectomy had intravesical injections of radioactive tracer and blue dye marker around the tumor followed by lymphoscintigraphy to visualize lymphatic drainage and detect sentinel nodes. Sentinel nodes were identified preoperatively by the blue color and increased radioactivity and were compared histopathologically with other routinely excised lymph nodes.Results: Sentinel nodes were detected in 85% (11 of 13) of patients. There were 4 patients who had sentinel nodes containing tumor cells, and each metastasis was only seen in the detected sentinel node. There were no false-negative sentinel nodes. Of the metastatic sentinel nodes 3 were located outside the normally excised lymph nodes of the obturator fossa.Conclusions: Sentinel nodes can be detected in patients with bladder cancer. The histopathological status of the identified sentinel nodes was diagnostic for all other excised lymph nodes. Sentinel nodes often seem to be located outside the obturator lymphatic field, which is normally examined during preoperative staging of bladder cancer.