用核素法探测宫颈癌前哨淋巴结的临床意义  

The clinical value of sentinel lymph node detection with radionuclide in early cervical cancer

作　　者：赛丽曼.木沙 丁岩[1] 

机构地区：[1]新疆医科大学第一附属医院妇科,新疆乌鲁木齐830011

出　　处：《新疆医科大学学报》2010年第3期302-304,共3页Journal of Xinjiang Medical University

摘　　要：目的探讨前哨淋巴结(SLN)检测在子宫颈癌根治术中的临床价值。方法用放射性核素定位法探测宫颈癌前哨淋巴结,选择2005年12月-2006年12月在新疆医科大学第一附属医院住院的妇女早期宫颈癌患者16例。术前均取子宫颈组织活检,病理证实为CINⅢ级累及腺体及子宫颈癌Ⅱb期以前的患者,所有病例根据术前盆腔检查情况按FIGO2000年标准进行临床分期。术前于宫颈12°、4°、8°在距肿瘤边缘5～10mm的黏膜下分别注射锝-99m硫化胶体,行即刻平面显像及断层显像(定位)或视情况行延迟显像。术中行γ探针探测前哨淋巴结,摘除有强放射性的淋巴结,进行病理学检查,行广泛子宫切除加盆腔淋巴结清扫术。结果16例患者共切除淋巴结138枚,平均每例9枚。8枚有SLN,其中7枚淋巴结病理阳性。130枚无SLN,病理结果均为阴性。SLN活检术灵敏度为100%,特异度99.2%。SLN分布情况与术前核素淋巴显像结果相符。结论SLN检测能准确地预测早期宫颈癌盆腔淋巴结的转移状况,但SLN活检术的可行性还需要更大样本量的研究来进一步评价。Objective To investigate the feasibility of sentinel lymph node（SLN）detection with radionuclide early cervical cancer patients.Methods During December 2005 to December 2006,a total of 16 patients with cervical cancer international federation of obstetrics and gynecology（FIGO）2000 from stage CINIII to IIb were eligible for the study.The day before surgery,the 99mTc-dextran（99mTc-DX）was injected into the cervix at 12°,4° and 8°.Before the operation followed by preoperative lymphoscintigraphy to detect the SLNs.During the operation,SLNs were identified from dissected LN by γ-counter.The samples of SLNs and non-SLNs（NSLN）were recorded separately and compared with the final pathology results.Results The sensitivity,specificity,and the accuracy of the SLN detecting to predict the metastasis of the pelvic lymph node were 100%,99.2%,100%,respectively.Conclusion SLNs can successfully predict the lymphatic metastasis in patients with cervical cancer.The clinical validity of this technique should be further evaluated.

关 键 词：宫颈癌 淋巴转移 前哨淋巴结 

分 类 号：R737.33[医药卫生—肿瘤]