早期子宫颈癌前哨淋巴结检测的临床意义

Clinical significance of sentinel lymph nodes detection in patients with early stage cervical carcer

目的 评价前哨淋巴结 (SLN)对早期宫颈癌盆腔淋巴结转移状况的预测价值 ,探讨检测SLN在指导早期宫颈癌盆腔淋巴清扫术中的意义。方法 对 2 0 0 2年 11月～ 2 0 0 3年 8月在山东省肿瘤医院手术治疗的 2 3例早期宫颈癌患者行SLN检测 ,分别利用亚甲蓝和99mTc 硫胶体定位并原位切除SLN送快速冰冻病理检查 ,然后行经腹广泛全子宫切除 +盆腔淋巴清扫术 ,比较SLN快速冰冻切片、SLN及其他盆腔淋巴结石蜡切片和抗角蛋白免疫组化染色结果。结果 2 3例患者中 19例成功检测到SLN ,共检出SLN 5 9枚 ,平均每例 3枚 ,SLN检出率为 83% (19/2 3)。SLN活检术灵敏性为 83% ,特异性为 10 0 % ,与病理检查结果符合率为 95 %。结论 SLN检测能较为准确地预测早期宫颈癌盆腔淋巴结的转移状况 。

Objective To study the value of sentinel lymph nodes(SLN)in prediction of the pelvic lymph nodes status and to determine the significance of SLN detection in pelvic lymph nodes dissection in patients with early stage cervical carcinoma Methods From November 2002 to August 2003, 23 patients with early stage cervical carcinoma planned to undergo radical hysterectomy and extensive pelvic lymph nodes dissection received an intracervical injection of technetium labeled sulfur colloid as well as blue dye to identify and perform resection of SLNs The SLNs were pathologically compared with non SLNs with frozen section, paraffin section, and anti cytokeratin immunohistochemical staining Results Out of 23 patients, SLNs were detected in 19 patients A total of 59 SLNs were identified and the mean was 3 per patient The detection rate of SLN was 83% Sensitivity, specificity and accuracy of the SLN biopsy were 83%, 100% and 95%, respectively Conclusion SLNs detection can predict the pelvic lymph nodes status in early stage cervical carcinoma,but the feasibility and safety of this technique to substitute conventional surgical modality should be evaluated by large series of prospective studies