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卵巢癌前哨淋巴结检测的可行性和有效性分析:系统评价 被引量:1

The feasibility and effectiveness of sentinel lymph node detection in ovarian neoplasms:a systematic review
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摘要 目的系统评价前哨淋巴结(SLN)检测在卵巢癌中的可行性和有效性。方法在中国知网、万方数据库、维普、PubMed、Embase、web of scienceCochrane library检索发表时间为2000年1月1日至2020年7月29日的关于卵巢癌SLN的研究。对纳入的文献进行质量评价及数据提取,计算SLN的显影率、灵敏度及阴性预测值。结果纳入8项前瞻性单臂研究,异质性I^(2)=57.41%>50%,且P<0.1。共纳入96例卵巢癌患者[国际妇产科联盟(FIGO)Ⅰ-Ⅱ期],其中93例在SLN显影后完成系统性盆腔及腹主动脉旁淋巴清扫。常见示踪剂为^(99)Tc^(m)、蓝染料或吲哚菁绿(ICG),最常见的注射部位为骨盆漏斗韧带和卵巢固有韧带。SLN的显影率为88.5%(85/96),平均数目为2~3个,76例指明SLN的位置分布,40.8%(31/76)仅位于腹主动脉旁,14.5%(11/76)仅位于盆腔,44.7%(34/76)位于腹主动脉旁和盆腔区。SLN可在肿瘤同侧或(和)对侧区域发现。SLN活检诊断早期卵巢癌淋巴结转移的灵敏度为90.9%(10/11),阴性预测值为98.8%(82/83)。结论卵巢癌SLN检测是可行的,是否可有效预测卵巢癌的淋巴结状态仍需大样本、多中心、前瞻性的临床研究来进一步验证。 Objective To evaluate the feasibility and effectiveness of sentinel lymph node(SLN)detection in the ovarian neoplasms.Methods A search of the literature describing ovarian SLN was performed using China National Knowledge Infrastructure(CNKI),WANFANG DATA,VIP,PubMed,Embase,web of science,Cochrane library from 2000.01.01 to 2020.07.29.The quality evaluation and data extraction of the included literature were conducted,and the development rate,sensitivity and negative predictive value of SLN were calculated.Results Eight prospective single-arm studies were included,with heterogeneity I^(2)=57.41%>50%,and the P<0.1.A total of 96 patients with ovarian cancer[Stage International Federation of Gynecology and Obstetrics(FIGO)Ⅰ-Ⅱ]were included,of whom 93 completed systematic pelvic and para-aortic lymphadenectomy after SLN detection.The most common tracers were technetium-99m radioactive colloid(^(99)Tc^(m)),blue dye or indocyanine green(ICG),and the most common injection sites were the infundibulopelvic ligaments and the proper ovarian ligaments.The SLN detection rate was 88.5%(85/96)and the average number was 2-3.SLN、vas found in the ipsilateral or contralateral regions of the tumor,40.8%(31/76)was found only in the para-aortic,14.5%(11/76)was found only in the pelvic,and 44.7%(34/76)was found only in the para-aortic and pelvic region.The sensitivity was 90.9%(10/11)and the negative predictive value was 98.8%(82/83)of lymph node metastasis.Conclusions SLN detection for ovarian neoplasms is feasible,and whether it can effectively predict lymph node status of ovarian cancer still needs large sample,multi-center,prospective clinical studies to further verify.
作者 王雨佳 蔡晶 孙思 王泽华 Wang Yujia;Cai Jing;Sun Si;Wang Zehua(Department of Obstetrics and Gynecology,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,China)
出处 《中国医师杂志》 CAS 2021年第2期171-177,共7页 Journal of Chinese Physician
基金 国家自然科学基金(81772781)。
关键词 卵巢肿瘤 前哨淋巴结 淋巴转移 Ovarian neoplasms Sentinel lymph node Lymphatic metastasis
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