宫颈癌前哨淋巴结的研究  

Study of sentinel lymph node in cervical cancer

作　　者：赵营[1] 黄守松 赵光日[1] 杜佩妍[1] 

机构地区：[1]广州医学院附属肿瘤医院妇瘤科,广州510095

出　　处：《中国实用医药》2007年第20期1-4,共4页China Practical Medicine

基　　金：广州市卫生局立项课题(2005-YB-192)

摘　　要：目的使用亚甲蓝作为示踪剂检测宫颈癌前哨淋巴结(SLN),分析影响SLN检出的因素。方法40例宫颈癌患者Ib～Ⅱb期,术前90～180 min在宫颈肿瘤周围组织中分4点(3、6、9、12点处)注入美蓝2～4 ml,蓝染的淋巴结即定为前哨淋巴结,按常规行宫颈癌根治术,所有淋巴结分组送病理检查。根据SLN检出率、假阴性率来探讨使用亚甲蓝检测宫颈癌SLN的影响因素。结果40例宫颈癌患者中淋巴管有蓝色染料摄取患者38例,蓝染淋巴结共67枚,其中左侧44枚,右侧23枚,前哨淋巴结识别成功31例,识别率为81.58%。成功识别前哨淋巴结的31例中,淋巴结转移28例,其中前哨淋巴结和盆腔淋巴结均转移16例,仅有前哨淋巴结转移12例,其中未行术前放化疗者检出率为100%,26例注射亚甲蓝量为2～3 ml的患者检出率仅为65.38%,显著低于注射量为3～4 ml的患者(100%),最常见部位为闭孔窝淋巴结。结论宫颈癌根治术前行染料法识别前哨淋巴结是安全可行的。一般注射量为3～4 ml,宫颈癌SIN定位个体差异较大,以闭孔窝最多见,术前治疗对SLN定位无影响。Objective To investigate the influential factors of identifying sentinel lymph node (SLN)with methylene blue in cervical cancer,and evaluate the feasibility of SLN detection.Methods 40 cases with cervical cancer at stage ofⅠb-Ⅱb was injected 2-4 ml of methylene blue into cervix at 4-6 sites around the tumor about 90-180 min before operation.The blue-dyed lymph node(BDLN)was con- sidered as SLN.Tumor characteristic surgical findings,and specific locations of lymphatic dye uptake were re- corded and correlated with pathology results.Results Among 40 patients underwent this detection,and dye uptake was seen in 38 patients.Total number of SLNS was 67,23 SLNS indentified located in right pelvic and 44 SLNS located in left The SLNS were successfully detected in 28 patients(28/31).28 patients were diagnosed with lymph node metastases and 16 cases had both positive SLNS and pelvic lymph nodes,12 cases had positive SLNS only.The predictive rate was 90.32% and the false-negative rate was zero.Conclusion SLN detection undergoing hysterectomy is feasible and safe.

关 键 词：宫颈癌 前哨淋巴结检测 染料法 

分 类 号：R737.33[医药卫生—肿瘤]