子宫内膜癌前哨淋巴结的研究进展

Research Progress on Sentinel Lymph Node of Endometrial Cancer

子宫内膜癌是常见的妇科恶性肿瘤,分期手术为全子宫切除+双侧输卵管卵巢切除+盆腔和(或)腹主动脉旁淋巴结切除。绝大部分患者诊断时尚处早期,病情仅局限于子宫,淋巴结转移风险小,若行系统性淋巴结切除术,可能未改善患者的生存状况,反而增加了术后并发症。前哨淋巴结活检可检测肿瘤区域的淋巴结转移情况并评估预后,适合子宫内膜癌早期患者,可避免过大的手术范围,提高生存质量。随着淋巴解剖、定位技术、病理评估等不断改善,前哨淋巴结的识别率以及淋巴结转移的检出率不断提高,能够更加精准地指导手术治疗。

Endometrial cancer is one of the common gynecologic malignant tumors,and the staging operation of endometrial cancer is total hysterectomy plus bilateral salpingo-oophorectomy plus pelvic and/or para-aortic lymphadenectomy.In most early stage patients the tumor is confined to the uterus with little risk of lymph node metastasis.If the systematic lymphadenectomy is performed the survival probability of patients may not be improved,but the postoperative complications might be increased.Sentinel lymph node biopsy can detect lymph node metastasis in the tumor area and provide the prognostic information.It can avoid excessive surgical scope and improve the quality of life,therefore it is suitable for patients with early endometrial cancer.With the progress of anatomy,localization techniques of lymph nodes and pathological assessment,the sentinel lymph node identification rate and the detection rate of lymph node metastasis have been continuously improved,which can guide the surgical treatment more accurately.In this article,we review the progress of sentinel lymph node research in endometrial cancer.