前哨淋巴结活检术在早期宫颈癌中的应用价值  

Clinical values of sentinel lymph node biopsy in cervical carcinoma

作　　者：郭海霞[1] 刘秀春[1] 王丽群[1] 钟柳英[2] 

机构地区：[1]广东医学院附属西乡人民医院,广东深圳518102 [2]广州医科大学附属第三人民医院,广东广州510150

出　　处：《热带医学杂志》2014年第1期96-98,共3页Journal of Tropical Medicine

摘　　要：目的探讨前哨淋巴结（SLN）活检术在早期宫颈癌中的应用价值。方法选取2006年1月至2011年4月在我院及特定医院就诊早期子宫颈癌拟接受腹式盆腔淋巴结清扫和广泛子宫切除术患者42例，术中确定SLN，并将切除的SLN行快速冰冻病理检查。且不管术中SLN快速病理检查结果如何，对所有患者均实行前哨淋巴结活检术（SLNB）和盆腔淋巴结清扫术，对于病理检查SLN淋巴结阴性的患者术后不需要补充放疗，阳性的患者术后需补充放疗。术后对比SLNB的SLN阳性和阴性率与盆腔淋巴结清扫结果的淋巴结阳性和阴性率是否符合，是否具有阳性和阴性预测效率。并对所有患者术后按SLN阴性和SLN阳性进行3～5年的跟踪随访。结果SLN的阳性和阴性率与盆腔淋巴结清扫结果的淋巴结阴性和阳性率基本符合，具有较高的阳性和阴性预测效率。对所有患者术后结局按SLN阴性和SLN阳性常规3~5年跟踪随访，结果显示两组在专科检查、盆腔B超、残端HPV检测、复发时间及部位、复发率、5年存活率6个方面比较，差异均无统计学意义（P〉0．05）。结论以SLNB代替传统的宫颈癌盆腔淋巴结清扫术技术在临床具有较高的可行性和准确性，为宫颈癌临床缩小手术范围并减小手术并发症开创了一个全新的思路。Objective To explore the application value of sentinel lymph node （SLN） biopsy in the early detection of cervical carcinoma. Methods Between January 2006 and April 2011, 42 patients with cervical cancer in our hospital or other special hospitals were selectedfor the treatment with pelvic lymphadenectomy or hysterectomy. Pelvic lymphadenectomy was performed and SLNs were removed for frozen sectioning examinations. Patients with positive results in the SLN biopsy were given additional radiation therapy. The positive and negative rate of SLN in SLNB and pelvic lymph node dissection were compared, and the patients were monitored for the disease recurrence for 3~5 years. Results Resuhs from the SLN biopsy matched with the that of pelvic cavity lymph node, indicating the high efficiency of SLN.For all patients with postoperative by SLN-negative and SLN-positive conventional 3 ~5 years follow-up ,according to the resuhs of the two groups in specialist checks, pelvic ultrasound, stump recurrence of HPV detection, recurrence and relapse rate and 5- year survival rate, showing no statistically significant difference （P〉0.05）. Conclusions SLNB can be used to replace the traditional scanning technique. This method can also reduce post-operation complications. A larger scale study should be conduct for further evaluation on the clinical application SLNB.

关 键 词：宫颈癌 广泛子宫切除术 盆腔淋巴结清扫 前哨淋巴结活检术 

分 类 号：R737.33[医药卫生—肿瘤]