早期子宫内膜癌前哨淋巴结活检和淋巴结微转移的研究进展

Advances in sentinel lymph node biopsy and lymph node micrometastasis in early endometrial cancer

子宫内膜癌(endometrial cancer,EC)是妇科常见恶性肿瘤之一,近年来很多研究指出前哨淋巴结活检(sentinel lymph node biopsy,SLNB)和前哨淋巴结(sentinel lymph node,SLN)病理超分期可以明确转移淋巴结位置和判定淋巴结转移与否,并被广泛应用于妇科肿瘤。早期子宫内膜癌淋巴结转移率低,然而淋巴结转移情况是指导术后辅助治疗和预测复发的独立危险因素。SLNB与病理超分期等检测手段结合可发现更多的淋巴结转移类型,尤其对淋巴结微转移具有较好检出效果,为早期子宫内膜癌诊疗提供更多依据。本文将对近年来有关早期子宫内膜癌SLNB技术、影响SLNB准确性相关问题、淋巴结微转移问题三方面进行简述,为促进早期子宫内膜癌精准手术治疗,减少术中风险和术后并发症提供可行性方案。

Endometrial cancer(EC)is one of the most common gynecological malignant tumors.In recent years,many studies have pointed out that sentinel lymph node biopsy(SLNB)and sentinel lymph node(SLN)pathological overstaging can determine the location of metastatic lymph nodes and determine whether they have metastatic lymph nodes or not,and are widely used in gynecological tumors.The rate of lymph node metastasis in early endometrial cancer is low,but lymph node metastasis is an independent risk factor to guide postoperative adjuvant therapy and predict recurrence.The combination of SLNB and pathological overstaging can find more types of lymph node metastasis,especially for lymph node micrometastasis,which provides more evidence for the diagnosis and treatment of early endometrial cancer.This article will briefly describe the SLNB technology of early endometrial cancer,the problems related to the accuracy of SLNB and lymph node micrometastasis in recent years,in order to provide a feasible scheme for promoting accurate surgical treatment of early endometrial cancer and reducing intraoperative risks and postoperative complications.