ICG示踪前哨淋巴结在早期低危和中高危子宫内膜癌治疗中的应用研究  

Application research of indocyanine green tracing sentinel lymph node in early low-risk and medium/high-risk endometrial cancer

作　　者：李芬[1] 古丽比亚·艾则孜 苑锦睿 温蒙科 沈谷群[1] LI Fen;Gulibiya·Aizezi;YUAN Jinrui;WEN Mengke;SHEN Guqun(Department of the Second Gynecology,the Affiliated Tumor Hospital,Xinjiang Medical University,Urumqi,830011,Xinjiang,China)

机构地区：[1]新疆医科大学附属肿瘤医院妇外二科,乌鲁木齐830011

出　　处：《中国性科学》2024年第1期24-28,共5页Chinese Journal of Human Sexuality

基　　金：新疆维吾尔自治区自然科学基金资助项目(2020D01C204);自治区科技支疆项目(2020E02125)。

摘　　要：目的探讨吲哚菁绿(ICG)示踪前哨淋巴结(SLN)在早期低危和中高危子宫内膜癌(EC)中的应用价值。方法选取2020年7月1日至2022年6月30日于新疆医科大学附属肿瘤医院经宫腔镜或诊断性刮宫病理证实为早期EC的62例患者作为研究对象。先行腹腔镜下SLN活检(SLNB),然后行全子宫、双侧附件切除术+腹主动脉旁、盆腔淋巴结切除术。将患者分为低危组(n=42)、中高危组(n=20),比较两组检出率、灵敏度、阴性预测值(NPV)及SLN分布特征;采用Logistic回归分析影响SLN显影的因素。结果低危组和中高危组EC患者的总检出率分别为90.3%和90.0%,灵敏度均为100%,NPV均为100%,两组间差异无统计学意义(P>0.05)。低危组EC患者SLN显影分布:髂外淋巴结和闭孔淋巴结62.0%,髂内淋巴结和骶前淋巴结34.0%,髂总淋巴结2.7%,腹主动脉旁淋巴结1.3%;中高危组EC患者SLN显影分布:髂外淋巴结和闭孔淋巴结63.3%,髂内淋巴结和骶前淋巴结33.3%,髂总淋巴结0%,腹主动脉旁3.3%;低危组与中高危组SLN显影分布比较,差异无统计学意义(P>0.05)。结论ICG示踪SLN在早期低危和中高危EC中均是有效和可行的。Objective To discuss the application value of indocyanine green(ICG)tracing of sentinel lymph nodes(SLN)in early stage low-risk and medium/high-risk endometrial cancer(EC).Methods A total of 62 patients with early EC confirmed by hysteroscopy or diagnostic curettage pathology at the Affiliated Tumor Hospital,Xinjiang Medical University from July 1,2020 to June 30,2022 were selected as study subjects.Laparoscopic sentinel lymph node biopsy(SLNB)was performed first,followed by total hysterectomy,bilateral adnexectomy+para aortic and pelvic lymph node dissection.The patients were divided into a low-risk group(n=42)and a medium/high-risk group(n=20),and the detection rate,sensitivity,negative predictive value(NPV),and SLN distribution characteristics were compared between the two groups.The factors affecting SLN visualization were analyzed by Logistic regression.Results The overall detection rates of EC patients in the low-risk group and the medium/high-risk group were 90.3%and 90.0%,respectively,and the sensitivities were both 100%and the NPVs were both 100%,with no statistically significant differences between the two groups(P>0.05).The distribution of SLN visualization in EC patients in the low-risk group showed:62.0%in external iliac lymph nodes and closed pore lymph nodes,34.0%in internal iliac lymph nodes and presacral lymph nodes,2.7%in common iliac lymph nodes,and 1.3%in para aortic lymph nodes.The distribution of SLN visualization in EC patients in the medium/high-risk group showed:63.3%in external iliac lymph nodes and closed pore lymph nodes,33.3%in internal iliac lymph nodes and presacral lymph nodes,0%in common iliac lymph nodes,and 3.3%in para aorta lymph nodes.The difference in the distribution of SLN visualization between the low-risk group and the medium/high-risk group was not statistically significant(P>0.05).Conclusions ICG tracing SLN is effective and feasible in both early low-risk and medium/high-risk EC.

关 键 词：吲哚菁绿 前哨淋巴结 低危 中高危 子宫内膜癌 

分 类 号：R711[医药卫生—妇产科学]