外阴癌患者腹股沟前哨淋巴结切除与传统腹股沟淋巴结切除腹股沟淋巴结转移灶大小的比较  

Inguinal sentinel node dissection versus sta-ndard inguinal node dissection in patients with vulvar cancer:A comparison of the size of metastasis detected in inguinal lymph nodes

作　　者：Robison K. Steinhoff M.M. Granai C.O. R.G.Moore 丁福 

机构地区：[1]Program in Women' s Oncology,Women and Infants' Hospital, Brown University, Providence, RI 02905- 2499, United States

出　　处：《世界核心医学期刊文摘（妇产科学分册）》2006年第6期57-58,共2页Core Journal in Obstetrics/Gynecology

摘　　要：Objective. The emergence of sentinel lymph node (SLN) technology has provided the ability for an in depth pathologic evaluation for the detection of metastasis to lymph nodes through the use of ultra- staging. The SLN has been shown to be predictive of the metastatic status of its nodal basin. More recently, SLN dissections have been employed in the evaluation of the inguinal lymphatic basins in patients with vulvar malignancies. We hypothesize that the average size of metastasis detected in non- palpable inguinal lymph nodes is smaller when detected through the use of SLN dissection and ultra- staging versus complete inguinal node dissection (CND).Methods. This was an IRB approved retrospective study. The tumor registry database was searched to identify all patients diagnosed with a vulvarmalignancy from 1990 to 2004. The records were reviewed to identify patients with inguinal lymph node metastasis. Only patients with non- palpable inguinal lymph nodes (metastasis 1 cm or less) were included in the analysis. All pathology slides were reviewed. The smallest metastatic foci of cells were measured from lymph nodes obtained through the traditional complete inguinal lymph node dissection (CND) and compared with the largest metastatic foci of cells detected in sentinel lymph node dissections. The mean size and standard deviation for each group was calculated and analyzed with a Mann- Whitney test. Results. There were 336 inguinal node dissections performed in patients identified with a vulvar malignancy. SLN dissections were performed in 52 groins and CND in 284 groins. Fifty- eight patients were found to have metastatic disease to the inguinal lymph nodes. Thirty of these patients had no evidence of lymph node metastasis on clinical exam or at the time of their EUA. There were 7 groins with metastasis detected through an SLN and 23 groins through a CND. The mean size of the metastatic foci detected in the SLN group was 2.52 mm (SD 1.55) and in the CND group was 4.35 mm(SD 2.63). This was not statistically significanObjective. The emergence of sentinel lymph node （SLN） technology has provided the ability for an in depth pathologic evaluation for the detection of metastasis to lymph nodes through the use of ultra-staging. The SLN has been shown to be predictive of the metastatic status of its nodal basin. More recently, SLN dissections have been employed in the evaluation of the inguinal lymphatic basins in patients with vulvar malignancies. We hypothesize that the average size of metastasis detected in non-alpable inguinal lymph nodes is smaller when detected through the use of SEN dissection and ultra-staging versus complete inguinal node dissection （CND） . Methods. This was an IRB approved retrospective study. The tumor registry database was searched to identify all patients diagnosed with a vulvarmalignancy from 1990 to 2004. The records were reviewed to identify patients with inguinal lymph node metastasis. Only patients with non-palpable inguinal lymph nodes （metastasis 1 cm or less） were included in the analysis. All pathology slides were reviewed. The smallest metastatic foci of cells were measured from lymph nodes obtained through the traditional complete inguinal lymph node dissection （CND） and compared with the largest metastatic foci of cells detected in sentinel lymph node dissections, The mean size and standard deviation for each group was calculated and analyzed with a Mann-Whitney test. Resuits. There were 336 inguinal node dissections performed in patients identified with a vulvar malignancy. SLN dissections were performed in 52 groins and CND in 284 groins. Fifty-eight patients were ~ound to have metastatic disease to the inguinal lymph nodes. Thirty of these patients had no evidence of lymph node metastasis on clinical exam or at the time of their EUA. There were 7 groins with metastasis detected through an SLN and 23 groins through a CND. The mean size of the metastatic foci detected in the SLN group was 2. 52 mm （SD 1.55） and in the CND group was 4. 35 mm（SD 2. 63）. This was not st

关 键 词：腹股沟淋巴结转移 淋巴结转移灶 前哨淋巴结切除 癌患者 外阴癌 恶性肿瘤患者 肿大淋巴结 全部切除术 分期诊断 切除技术 

分 类 号：R739.63[医药卫生—肿瘤] R735.2[医药卫生—临床医学]