前哨淋巴结检测在早期宫颈癌临床应用的研究进展

Review of studies of sentinel nodes detection in early stage cervical cancer

目的:总结近年来国内外前哨淋巴结活检术(SLNB)在早期宫颈癌中的应用进展。方法:应用PubMed及CNKI全文数据库,以前哨淋巴结、宫颈颈癌为关键词检索2000-01-2007-02相关宫颈癌前哨淋巴结的文献。文献纳入标准:1)影响前哨淋巴结的检出因素研究;2)前哨淋巴结识别方法的研究;3)前哨淋巴结活检术在早期宫颈癌研究。粗选有105篇的相关文献,根据纳入标准,纳入分析23篇文献。结果:前哨淋巴结是肿瘤细胞区域淋巴引流发生转移必经的第一站淋巴结。在早期宫颈癌研究中,可以代表盆腔淋巴结的转移状态。患者的临床病理特征、示踪剂、病理学检查方法是影响SLNB的主要因素。SLNB提高了早期宫颈癌保留生育功能手术的安全性。目前前哨淋巴结活检术在早期宫颈癌研究中显示此项技术的可行性及安全性。结论:研究前哨淋巴结活检术在早期宫颈癌中的应用具有重要意义,可以减少手术的并发症,提高微转移的检出率。

OBJECTIVE：To review the advances of sentinel lymph node biopsy in early stage cervical cancer.METHODS：The literature about sentinel node biopsy in early stage cervical cancer was retrieved in PubMed and CNKI from 2000-01-2007-02. The key words were cervical carcinoma and sentinel lymph node.Selection standard：1） factors affecting the detection rate of the sentinel lymph node,2） the techenique of identification of the sentinel lymph node,3）the development of the sentinel nodes biopsy in early stage cervical cancer. A total of 105 papers related were collected, and 23 were used lastly. RESULTS： The sentinel node is defined as the first node in the lymphatic system that drains a tumor site and represents the status of pelvic lymphatic spread. The clinicopathological characteristics of patients, the selection of tracer and, the methods of pathological evaluation are the factors that might affect the success rate of SLNB. Recently, SLNB improves the safety in this fertility sparing surgery. SLNB shows the feasibility and security in the study of early stage cervical cancer.CONCLUSIONS：It is important to study the application of the sentinel lymph node biopsy in the early stage cervical cancer. It can help reduce the morbidity of the surgical treatment and increase the detection rate of the micrometastasis.