摘要
目的 探索子宫颈癌根治术中淋巴显影和前哨淋巴结识别的方法及其可行性 ,评价前哨淋巴结预测盆腔淋巴结有无肿瘤转移的准确性。方法 应用染料法对 2 0例宫颈癌患者 (临床分期为Ⅰb期 3例、Ⅱa期 12例、Ⅱb期 5例 )在根治术中于宫颈肿瘤周围的正常组织中分 4点 (3、6、9、12点处 )注入美蓝或专利蓝溶液 4ml,识别和定位蓝染的淋巴结 (即前哨淋巴结 ) ,然后再按常规行盆腔淋巴清扫术 ,所有淋巴结一起送病理检查。结果 2 0例宫颈癌患者中淋巴管有蓝色染料摄取者 18例 ,共有蓝染淋巴结 33枚 ,其中左侧 15枚 ,右侧 18枚 ,前哨淋巴结识别成功 14例 ,识别率为 78%(14 /18)。共有 6例有淋巴结转移 ,淋巴结转移率为 33% (6 /18)。成功识别前哨淋巴结的 14例中 ,淋巴结转移 5例 ,其中前哨淋巴结和盆腔淋巴结均转移者 2例 ,仅有前哨淋巴结转移者 3例 ,准确性为10 0 % ,假阴性率为 0。结论 宫颈癌根治术中淋巴显影和前哨淋巴结识别技术是可行的 。
Objective To investigate the feasibility of sentinel lymph node (SLN) detection in patients with cervical cancer undergoing radical hysterectomy Methods Twenty patients with cervical cancer at stage Ⅰb ( n =3), stage Ⅱa ( n =12) and stage Ⅱb ( n =5) underwent SLNs detection by using blue dye Four ml of methlene blue or lymphazurin was injected into the cervix at 4 points around the tumor at the time of radical hysterectomy and bilateral pelvic lymphadenectomy Tumor characteristics, surgical findings, and specific locations of lymphatic dye uptake were recorded and correlated with final pathology results Results Among 20 patients underwent this detection, dye uptake was seen in 18 patients Total number of SLNs were 33 Eighteen SLNs identified located in right pelvic and 15 SLNs located in left The SLNs were successfully detected in 78% patients (14/18) Six patients (33%) were diagnosed with lymph node metastases and there were 5 patients with positive nodes in the group of SLN Two patients had both positive SLNs and pelvic lymph nodes Three patients had positive SLNs only The predictive rate was 100% and the false negative rate was zero Conclusion SLN detection undergoing radical hysterectomy is feasible and safe, however, the detection rate of SLN needs improvement
出处
《中华妇产科杂志》
CAS
CSCD
北大核心
2004年第1期7-9,共3页
Chinese Journal of Obstetrics and Gynecology
基金
上海市自然科学基金资助项目 (0 2ZB14 0 17)
