前哨淋巴结活检术在N0期阴茎癌的临床意义

The clinical significance of Sentinel lymph node biopsy in N0 penile cancer

背景与目的:阴茎癌在原发病灶切除后是否行腹股沟淋巴结清扫术一直存在争议,本文旨在探讨前哨淋巴结活检术(sentinel lymph node biopsy,SLNB)在无肿大淋巴结的pN0期阴茎癌患者中的可行性及临床意义。方法:回顾性分析军事医学科学院附属医院泌尿外科2004年3月—2012年08月收治的25例pN0期阴茎癌患者的临床资料,切除原发病灶后均利用亚甲蓝蓝染,并同时行改良的腹股沟淋巴结清扫术(inguinallymph node dissection,ILND)。结果:前哨淋巴结(sentinel lymph node,SLN)实际检测出24例,成功率为96%(24/25),阳性7例,阴性17例;本组准确率为95.8%(23/24),灵敏度为87.5%(7/8),假阴性率为12.5%(1/8),无假阳性。SLNB病理结果与常规病理结果比较具有高度一致性(Kappa value=0.903,P<0.01)。结论:目前SLNB对于pN0期阴茎癌患者是否行淋巴结清扫术仍具有重要的的指导意义。

Background and purpose： The inguinal lymph node dissection of penile cancer after resection of the primary lesion has been controversial, this paper aimed to preliminary study the feasibility and clinical significance of sentinel lymph node biopsy （SLNB） in pN0 stage patients with penile cancer. Methods： We analyzed retrospectively the clinical data of 25 patients of pN0 penile cancers admitted in our department from Mar. 2004 to Aug. 2012, all the patients used the methylene blue for SLNB after having resection of the primary lesion, at the same time received modified inguinal lymph node dissection （ILND）. Results： The sentinel lymph node （SLN） of 24 patients had be actually detected, the success rate was 96% （24/25）, 7 was positive, 17 was negative; The accuracy was 95.8% （23/24）, sensitivity was 87.5% （7/8）, false negative rate was 12.5% （1/8）, and no false positive. There is a high degree of consistency between the SLNB grope and the routine grope （Kappa value=0.903, P〈0.01）. Conclusion： SLNB for pN0 stage penile cancers without swollen lymph node had still important guiding significance.