摘要
目的:探讨联合应用吲哚菁绿(ICG)和亚甲蓝(ISB)在子宫恶性肿瘤手术中示踪前哨淋巴结(SLN)的应用价值。方法:选择于承德医学院附属医院因子宫恶性肿瘤进行开腹手术治疗的患者60例(包括34例子宫内膜癌和26例宫颈癌患者),其中宫颈癌患者选择于宫颈的6点及12点注射亚甲蓝1mL,同时于3、9点注射吲哚菁绿1mL,子宫内膜癌患者选择于癌灶周围肌层的4个不同位置分别注射亚甲蓝及吲哚菁绿各1mL,术后将显影的SLN和非显影的淋巴结分别作出标记,并送病理学检查。结果:在子宫内膜癌和宫颈癌患者的开腹手术治疗中,将ICG与ISB进行联合示踪,其前哨淋巴结的检出率为91.7%(55/60),灵敏度100%(4/4),阴性预测值为100%(51/51)。ICG、ISB单一检出率分别为81.7%(49/60)、71.7%(43/60)。二者联合检出率高于单一检出率、ICG的检出率高于ISB(P<0.05)。结论:吲哚菁绿和亚甲蓝联合检测SLN具有较高的敏感性和阴性预测值,联合检测法优于单一检测法,在早期子宫恶性肿瘤的开腹手术中,预测淋巴结的转移状态具有一定的应用前景。
Objective:To evaluate the value of indocyanine green(ICG)and isosulfan blue(ISB)for identifying sentinel lymph node(SLN)in uterine malignant carcinoma.Methods:60 patients(34 cases of endometrial cancer and 26 cases of cervical cancer)who underwent open surgery in affiliated hospital of chengde medical college were selected.ISB and ICG were injected into the cervix of cervical cancer and around the lesion in the patients with endometrial cancer.All the SLN and other lymph nodes were labeled postoperatively and sent for routine pathological examination.Results:The total detection rate of pelvic SLN was 91.7%(55/60)using ICG combined with ISB,the sensitivity and negative predictive value were all 100%.The detection rate of ICG and ISB was 81.7%(49/60)and 71.7%(43/60),respectively.Detection rate of SLN with combined technique was higher than that with single technique,ICG detection rate was higher than ISB technique(P<0.05).Conclusion:ICG combined with ISB tracing SLN showed high sensitivity and negative predictive value.Combined detection method is superior to single technique and will have a certain application prospect in prediction of lymph node metastasis in open surgery of uterine malignant carcinoma.
作者
庄新荣
李淑梅
张桂香
ZHUANG Xinrong;LI Shumei;ZHANG Guixiang(The Affiliated Hospital of Chengde Medical College,Hebei Chengde 067000,China)
出处
《河北医学》
CAS
2020年第5期796-800,共5页
Hebei Medicine
关键词
前哨淋巴结
子宫内膜癌
宫颈癌
吲哚菁绿
亚甲蓝
Sentinel lymph node
Endometrial carcinoma
Cervical cancer
Indocyanine green
Isosulfan blue
