前哨淋巴结示踪联合病理超分期技术在早期高危型子宫内膜癌中的应用研究  

Application of sentinel lymph node mapping combined with pathological ultrastaging in high-risk early endometrial cancer

作　　者：陈国伟[1] 方双 韦露薇[1] 贺红英 CHEN Guowei;FANG Shuang;WEI Luwei;HE Hongying(Department of Gynecological Oncology,Liuzhou Worker’s Hospital,Liuzhou,Guangxi 545005,China)

机构地区：[1]广西柳州市工人医院,545005 [2]广西柳州市柳铁中心医院

出　　处：《中国妇产科临床杂志》2020年第4期349-353,共5页Chinese Journal of Clinical Obstetrics and Gynecology

基　　金：广西壮族自治区卫生健康委员会(Z20190067)。

摘　　要：目的评估前哨淋巴结示踪技术联合病理超分期技术在具有高危因素的子宫内膜癌患者中的临床意义。方法筛选2019年3月至2019年12月本院具有高危因素的早期子宫内膜癌手术患者29例。对所有入组患者采用纳米炭、吲哚菁绿或两者联合进行前哨淋巴结示踪术+全面分期手术。前哨淋巴结均进行病理超分期。结果 29例患者检出率100%,其中82.76%(24/29)为双侧显影。主要显影部位在闭孔区。常规病理检查提示1例假阴性病理,即前哨淋巴结可以正确识别出96.55%(28/29)的淋巴结转移患者。经过超分期病理检查后,假阴性率降至0,阴性预测值100%。结论前哨淋巴结技术在高危型子宫内膜癌淋巴结评估是安全有效的,尤其结合超分期技术可以提高淋巴结转移的检出率。有待扩大样本量进一步明确前哨淋巴结技术的应用指征。Objective To evaluate the clinical significance of lymph node mapping(SLNM)technique in combination with ultrastaging in patients with endometrial cancer with high risk factors.Methods A total of 29 patients with early endometrial cancer with high risk factors were screened from March 2019 to December 2019.Indocinine green or combined carbon nanotracer in sentinel lymph nodes were performed plus comprehensive staging surgery in all enrolled patients.Pathological superstaging were underwent in all sentinel lymph nodes.Results The detection rate of 29 patients was 100%,among which 82.76%(24/29)was bilateral imaging.The main developing site is in the obturator region.Routine pathological examination suggested that one case with false negative pathology,that is,sentinel lymph nodes could correctly identify 96.55%(28/29)of patients with lymph node metastasis.After pathological examination,the false negative rate was reduced to 0 and the negative predictive value was 100%.Conclusion The sentinel lymph node technique is safe and effective in the assessment of lymph nodes in high-risk early endometrial cancer,the detection rate of lymph node metastasis can be improved by super staging technique.The sample size needs to be expanded to further clarify the application of the sentinel lymph node technique.

关 键 词：前哨淋巴结 子宫内膜癌 超分期 高危因素 淋巴结转移 

分 类 号：R737.33[医药卫生—肿瘤]