前哨淋巴结活检术联合病理超分期检测在早期宫颈癌诊治中的应用价值  

Application value of sentinel lymph node biopsy combined with pathological staging in diagnosis and treatment of early cervical cancer

作　　者：陈玉莹 李洋洋[1] 李卓[1] 崔满华[2] 贾妍[2] CHEN Yuying;LI Yangyang;LI Zhuo;CUI Manhua;JIA Yan(Reproductive medicine prenatal genetics Center,The First Hospital of Jilin University,Changchun,Jilin130021;Department of Gynecology,The Second Hospital of Jilin University,Changchun,Jilin130025,China)

机构地区：[1]吉林大学第一医院生殖医学·产前遗传中心,长春130021 [2]吉林大学第二医院妇产科,长春130025

出　　处：《中国妇产科临床杂志》2023年第6期587-591,共5页Chinese Journal of Clinical Obstetrics and Gynecology

摘　　要：目的分析前哨淋巴结活检术合并病理超分期检测在早期宫颈癌中的敏感性、阴性预测值等指标,评估其临床应用价值。方法回顾性分析2018年8月至2020年8月在吉林大学第二医院接受手术治疗的100例早期宫颈癌患者,均采用纳米碳作为示踪剂,行前哨淋巴结活检术+全面分期手术。对于前哨淋巴结进行病理超分期检测。结果在100例患者中,前哨淋巴结活检的敏感性为93.3%(14/15),特异性为89.4%(76/85),准确性为100.0%(90/90),阴性预测值为100%(76/76),假阴性率为0.0%(0/15)。病理超分期检测微转移的检出率为10.2%(5/49),常规病理学染色合并病理超分期检测淋巴结转移的检出率为18.3%(11/60)。结论在早期宫颈癌患者中,前哨淋巴结活检合并病理超分期技术具有很高的敏感性和阴性预测值。对于双侧前哨淋巴结显影且病理超分期检测呈阴性者,可仅行前哨淋巴结切除术。Objective To analyze the sensitivity and negative predictive value of sentinel lymph node biopsy(SLNB)combined with pathological ultrastaging in early cervical cancer,and evaluate its clinical application value.Methods A retrospective analysis was performed on 100 patients with early cervical cancer who received surgical treatment from August 2018 to August 2020 in the Second Hospital of Jilin University,and all were performed with sentinel lymph nodes biopsy plus comprehensive staging surgery using carbon nanotracer.Pathological ultrastaging were underwent in sentinel lymph nodes.Results The sensitivity of SLNB is 93.3%(14/15),the specificity is 89.4%(76/85),the accuracy is 100.0%(90/90),the negative predictive value is 100%(76/76),and the false negative rate is 0.0%(0/15).The detection rate of micrometastasis and isolated tumor cells by pathological ultra-staging was 10.2%(5/49),and the detection rate of lymph node metastasis by conventional pathological staining combined with pathological ultra-staging technology was 18.3%(11/60).Conclusion Sentinel lymph node biopsy combined with pathological ultrastaging has high sensitivity and negative predictive value in patients with early cervical cancer.For patients with bilateral sentinel lymph node imaging and negative pathological ultrastaging,only sentinel lymph node resection can be considered.

关 键 词：宫颈癌 前哨淋巴结活检 病理超分期 盆腔淋巴结切除 

分 类 号：R737.33[医药卫生—肿瘤]