前哨淋巴结在88例早期子宫内膜癌术中的应用

Detection of Sentinel Lymph Node in Early Endometrial Carcinoma and Its Clinical Application

[目的]分析前哨淋巴结(sentinel lymph node,SLN)在早期子宫内膜癌术中的应用价值。[方法]将88例行手术治疗的早期子宫内膜癌患者纳入研究,行亚甲蓝注射液前哨淋巴结显影探查;记录SLN检出情况和盆腔淋巴结转移情况。[结果]①前哨淋巴结检出率(SLN阳性率)为94.32%。②肿瘤直径≤2cm 的患者SNL检出率为100.00%,肿瘤直径>2cm 的患者SLN检出率为87.00%。SNL检出率在不同注射位置及不同年龄段中明显差异。③SLN与盆腹腔淋巴结分布:45.76%SLN分布在髂外,其次为闭孔(23.99%);37.99%的盆腹腔淋巴结分布在髂外,29.06%分布在闭孔。④亚甲蓝注射液示踪SNL诊断盆腔淋巴结转移特异性、敏感度分别为95.58%和100.00%。[结论]示踪前哨淋巴结用于早期子宫内膜癌术中能清晰显影淋巴管,能辅助判断盆腹腔淋巴结是否转移,对淋巴结精准清扫、治疗及预后有指导意义。

[Objective] To evaluate the clinical application of detecting sentinel lymph node(SLN) in early endometrial carcinoma. [Methods] Eighty-eight patients with early endometrial carcinoma underwent surgical treatment,the methylthioninium chloride was injected to trace SLN during the operation. The detection rate of SLN and pelvic lymph node metastasis were recorded,and the diagnostic value of SLN for pelvic lymph node metastasis was evaluated. [Results] The overall positive rate of SLN was 94.32%. The detection rate of SLN for patients with tumor diameter ≤2cm was 100.00%,while that for patients with tumor diameter >2cm was 87.00%(P<0.05). There was no significant difference in detection rate of SNL among patients with different ages or different injecting positions. The 45.76% of abdominopelvic SLNs were distributed in the external iliac artery,followed by obturator foramen(23.99%)(P<0.05); while 37.99% of abdominopelvic lymph nodes were distributed in the external iliac artery,followed by obturator foramen(29.06%)(P<0.05). The specificity and sensitivity of SLN detection in diagnosis of pelvic lymph node metastasis was 95.58% and 100.00%,respectively. [Conclusion] Detection of SLNs with methylthioninium chloride injection during operation has high sensitivity and specificity in diagnosis of abdominopelvic lymph node metastasis in patients with early endometrial carcinoma.