女性生殖道癌瘤的前哨淋巴结

Sentinel Lymph Notes in Female Reproductive Tract Cancer

为减少常规根治性妇科手术并降低病死率,在女性生殖道癌瘤中业已尝试前哨淋巴结诊治技术。前哨淋巴结确认可采用淋巴图或淋巴系闪烁造影术。外阴癌与子宫颈癌淋巴转移常顺序发生,前哨淋巴结确认能避免未发生转移患者进行不必要的根治性手术。这一新技术包括肿瘤“超分期”、多步分层切片及免疫组化染色,该技术的应用使淋巴转移的检测更为准确,阳性率更高。前哨淋巴结预测淋巴转移的准确性与切除疗效还有待长期随诊观察。

To reduce extensive radical procedures and decrease morbidity in gynecologic malignancies,much effort is being focused on implementing less aggressive interventions.Two different approaches such as lymphatic mapping and lymphoscintigraphy are currently used to identify sentinel lymph nodes.In vulvar and cervical carcinomas,metastatic spread of disease commonly follows stepwise progressive drainage.Thus,sentinel lymph node identification may significantly reduce the number of patients undergoing unnecessary,extensive lymphadenectomy in the absence of metastatic disease.The addition of novel techniques,such as histopathologic ultrastaging,step sectioning,and immunohistochemistry staining,will help increase the accuracy and rate of detection of the disease.Any definitive statements can be made to the validity of sentinel lymphadenectomy until we got data with long-term follow-up.