宫颈癌前哨淋巴结的临床研究

Clinical Research of Sentinel Lymph Node in Cervical Cancer

目的：探讨亚甲蓝用于检测前哨淋巴结预测宫颈癌盆腔淋巴结转移的可行性和临床意义。方法：选择本院2010年1月-2014年1月收治的40例Ⅰb~Ⅱb期宫颈癌患者作为研究对象,对40例患者术前注射亚甲蓝示踪剂,注射后等待90~180 min后行盆腔淋巴结清扫术以及广泛子宫切除术,在术中把蓝染的淋巴结认定为前哨淋巴结,把所有蓝染的以及未蓝染的切除后的淋巴结分开送检,并分析病理结果。结果：40例宫颈癌患者中,使用亚甲蓝试剂成功定位出37例患者的前哨淋巴结,检出率为92.5%。全部40例患者均经病理确诊存在盆腔淋巴结转移,前哨淋巴结阳性11例。蓝染前哨淋巴结对于盆腔淋巴结转移预测率为92.5%,假阴性发现率为0。结论：使用亚甲蓝作为示踪剂检测前哨淋巴结是可行的,可以非常准确的识别以及定位前哨淋巴结的位置,判断是否出现盆腔内淋巴结转移,具有一定的临床价值。

Objective：To explore the feasibility and clinical effect of methylene blue used in the detection of sentinel lymph node which used to forecast pelvic lymphonode metastasis of cervical cancer.Method：40 patients with cervical cancer of stage Ⅰb to Ⅱb in our hospital from January 2010 and January 2014 were selected as the research objects.The injection of methylene blue were given to the 40 patients before operation,after waiting 90 to 180 minutes,they were given pelvic lymphadenectomy and radical hysterectomy.During the operation,the blue dyed lymph gland was regarded as the sentinel lymph node,then the blue dyed and un-blue dyed lymph glands which were removed from the operation were tested respectively.Then the pathology result was analyzed.Result：Among the 40 cervical cancer patients,37 patients were successfully detected with sentinel lymph nodes by methylene blue.The detection rate was 92.5%.According to the pathology result,all patients were with pelvic lymphonode metastasis and 11 patients with sentinel lymph node positive.The prediction rate of blue dyed sentinel lymph node to the pelvic lymphonode metastasis was 92.5%.The discovery rate of false negative was 0.Conclusion：It＇s feasible to apply methylene blue as tracer to test the sentinel lymph node.The use of methylene blue can identify and locate the position of sentinel lymph node quite accurately.Besides,the use of it can also estimate whether lymph gland shift or not,which is of great clinical value.