美兰注射在早期宫颈癌前哨淋巴结检查中的应用价值

Application Value of Meilan Injection in Sentinel Lymph Node Examination of Early Cervical Cancer

目的探讨美兰注射在早期宫颈癌前哨淋巴结检查中的应用价值。方法选取2014年1月至2018年12月我院拟行宫颈癌手术的72例患者,随机分为A组、 B组、 C组、 D组,各18例。术前5～10 min在A组宫颈12点位置、 B组3点位置、C组6点位置及D组9点位置注射美兰,术中根据美兰染色情况确认前哨淋巴结,观察不同宫颈位置前哨淋巴结的染色情况,并在切除染色前哨淋巴结后,常规清除盆腔淋巴结,所有切除淋巴结均送病理检查,比较各组前哨淋巴结不同标注区域检出阳性率。结果 C组前哨淋巴结检出阳性率为88.89%,显著高于A组的11.11%、 B组的5.56%及D组的16.67%(P <0.05)。前哨淋巴结病理检查准确率为97.22%,显著高于非前哨淋巴结的84.72%(P <0.05)。结论美兰注射在早期宫颈癌患者前哨淋巴结清扫中有重要标记作用,在宫颈6点方向注射染色效果最为显著。

Objective To explore the application value of Meilan injection in sentinel lymph node examination of early cervical cancer. Methods 72 cases of patients preparing for cervical cancer surgery in our hospital from January 2014 to December 2018 were selected and randomly divided into group A, group B, group C and group D, with 18 cases in each group. 5 to 10 minutes before surgery, 12 o’clock position of cervix in group A, 3 o’clock position in group B, 6 o’clock position in group C and 9 o’clock position in group D were injected with Meilan. In the operation, the sentinel lymph nodes were confirmed according to the staining of Meilan, and the staining of sentinel lymph nodes at different cervical positions was observed. After the stained sentinel lymph nodes were removed, the pelvic lymph nodes were routinely removed. All these lymph nodes were sent for pathological examination. The positive detection rates of different labeled areas of sentinel lymph nodes were compared among four groups. Results The positive detection rate of sentinel lymph nodes in group C was 88.89%, significantly higher than 11.11% in group A, 5.56% in group B and 16.67% in group D(P<0.05). The accuracy of pathological examination of sentinel lymph node was 97.22%, significantly higher than 84.72% of non-sentinel lymph nodes(P<0.05).Conclusions Meilan injection has an important labeled role in sentinel lymph node dissection of patients with early cervical cancer. The effect of injection in the 6 o’clock position of cervix is the most significant.