吲哚菁绿荧光检测在子宫内膜癌前哨淋巴结定位中的应用价值  

Application Value of Assessing Sentinel Lymph Node Mapping Using Indocyanine Green Fluorescence Detection Technology in Endometrial Cancer

作　　者：皇甫玉爽 郭健 宋晓晖 HUANGFU Yushuang;GUO Jian;SONG Xiaohui(Wuhan Children＇s Hospital（Wuhan Maternal and Child Healthcare Hospital）,Tongji Medical College,Huazhong University of Science and Technology,Wuhan Hubei 430000,China)

机构地区：[1]华中科技大学同济医学院附属武汉儿童医院(武汉市妇幼保健院),湖北武汉430000

出　　处：《实用妇产科杂志》2018年第8期609-612,共4页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:探讨吲哚菁绿荧光(ICG)检测技术在子宫内膜癌前哨淋巴结(SLN)定位中的应用价值。方法:选择2015年2月至2017年2月在我院行腹腔镜下广泛全子宫切除联合盆腹腔淋巴结切除术的患者共64例。根据随机数表将患者分为亚甲蓝组(ISB组)32例和亚甲蓝联合吲哚菁绿组(ISB+ICG组)32例。ISB组患者仅使用亚甲蓝定位SLN,而ISB+ICG组患者在亚甲蓝的基础上,采用吲哚菁绿荧光定位SLN。比较两组患者的术中情况(包括手术时间、术中出血、SLN切除时间、淋巴结切除数量等)、手术标本病理情况及SLN病理检查结果。比较两种检查方式用于子宫内膜癌SLN定位的准确率、灵敏度、特异度。结果:两组患者的手术时间、术中出血量及SLN切除时间比较,差异无统计学意义(P>0.05)。两组患者术中切除的盆腔淋巴结数量差异无统计学意义(P>0.05)。ISB组中有17例(53.13%)进行了主动脉旁淋巴结切除术,ISB+ICG组有15例(46.88%),两组间差异无统计学意义(P>0.05);两组接受主动脉旁淋巴结切除术的患者切除主动脉旁淋巴结数量差异亦无统计学意义(P>0.05)。两组患者手术标本病理检查结果比较,肿瘤侵犯淋巴血管、肿瘤侵犯深度>50%、肿瘤侵犯宫颈、肿瘤直径>2 cm的病例比例差异无统计学意义(P>0.05)。两组患者肿瘤的病理分级比较,差异无统计学意义(P>0.05)。ISB组SLN准确率为65.63%(21/32),特异度为54.55%(6/11),敏感度100%(21/21)。而ISB+ICG组的准确率为78.13%(25/32),特异度为71.43%(5/7),敏感度100%(25/25)。结论:亚甲蓝联合吲哚菁绿荧光检测技术应用于子宫内膜癌SLN定位,其准确率和特异度均高于亚甲蓝染色技术,值得进一步在临床推广。Objective： To study the application value of assessing sentinel lymph node（ SLN） mapping using indocyanine green（ ICG） fluorescence detection technology in patients with endometrial cancer.Methods： A total of 64 patients with endometrial cancer,who underwent laparoscopic extensive hysterectomy combined with pelvic lymph node dissection in our hospital from February 2015 to February 2017,were involved in this study.Based on random number table,those patients were divided into two groups,Isosulfan blue（ ISB） group and ISB＋ICG group.32 patients were included in ISB group and were assessed SLN mapping by only ISB,while the other 32 ones were in ISB＋ICG group,who were assessed SLN mapping by both ISB and ICG fluorescence.Intra-operative findings（ including operation time,intraoperative bleeding amount,duration of SLN mapping,the number of lymph nodes dissected and so on）,the pathological diagnosis of specimens and SLN were compared between two groups.Furthermore,the accuracy,sensitivity and specificity of two methods were compared.Results： There was no significant difference of operation time,intraoperative bleeding amount and duration of SLN mapping between two groups（ P〈0. 05）.The number of dissected lymph nodes during operation was similar in two groups（ P〉0. 05）.17 cases（ 53. 13%）in ISB group and 15 cases（ 46. 88%） in ISB＋ICG group had para-aortic lymph node dissection.The proportion of para-aortic lymph node dissection was no obviously different（ P〈0. 05）,and meanwhile,the number of dissected para-aortic lymph nodes were similar in two groups（ P〈0. 05）.When comparing the pathological diagnosis of specimens,the proportion of cases with invasion of lymphatic vessels,invasion depth more than 50%,invasion of the cervix or tumor diameter more than 2 cm,no significant difference was found between the two groups（ P〉0. 05）. No significant difference of pathology grading was observed between two groups（ P〉0. 05）. The accuracy,specificity and sensitivi

关 键 词：子宫内膜癌 前哨淋巴结 吲哚菁绿 亚甲蓝 

分 类 号：R737.33[医药卫生—肿瘤]