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中国临床研究英文版:2020,33(11):1544-1547
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前哨淋巴结绘图活检在高危性子宫内膜癌的应用
(湖北省人民医院 武汉大学人民医院妇产科,湖北 武汉 430060)
Utility of sentinel lymph node mapping in high-risk endometrial cancer
(Department of Obstetrics and Gynecology,Remin Hospital of Wuhan University,Wuhan,Hubei 430060,China)
摘要
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Received:February 11, 2020   Published Online:November 20, 2020
中文摘要: 目的 研究在高危性子宫内膜癌盆腔淋巴结切除术中进行前哨淋巴结(SLN)绘图活检的可行性。方法 选择2015年1月至2019年8月行腹腔镜下全子宫切除术+盆腔淋巴结和腹主动脉旁淋巴结切除术+双侧附件切除术的79例高危性子宫内膜癌(低分化的子宫内膜样腺癌、浆液性癌、透明细胞癌和癌肉瘤)患者,分析上述子宫内膜癌SLN定位的准确率、灵敏度、特异度,术后辅助治疗和随访肿瘤复发情况。结果 所有患者均在SLN导引下行系统淋巴结切除术,14例患者术后病理检测盆腔淋巴结转移阳性,13例患者有SLN显示,SLN定位的准确率为92.8%(13/14),特异度为98.48%(65/66),敏感度为100%(13/13)。15例患者在术后15个月内出现复发,6例术后出现盆腔淋巴结复发的患者术中均有SLN显示。结论 对高危性子宫内膜癌进行术中检测SLN具有可行性,但需要大样本的研究来证实在高危性子宫内膜癌肿瘤前哨淋巴结切除能够替代系统淋巴结切除。
Abstract:Objective To study the feasibility of sentinel lymph node (SLN) mapping during pelvic lymphadenectomy of women with high-risk endometrial cancer.Methods SLN mapping was performed in 79 patients with high-risk endometrial carcinoma (poorly differentiated endometrial adenocarcinoma,serous carcinoma,clear cell carcinoma and carcinosarcoma),who underwent laparoscopic total hysterectomy,pelvic and para-aortic lymphadenectomy plus bilateral adnexectomy from January 2015 to August 2019.The accuracy,sensitivity and specificity of SLN localization,postoperative adjuvant therapy and tumor recurrence were analyzed.Results Of 14 patients with pelvic lymph node metastasis confirmed by pathological examination,13 cases showed metastasis in SLN.The accuracy,specificity and sensitivity of SLN mapping were 92.8%(13/14),98.48%(65/66) and 100%(13/13),respectively.Out of 15 patients with recurrence during 15 months after operation,there were 6 patients with pelvic lymph node recurrence,which were consistent with the intraoperative SLN analysis.ConclusionIn the patients with high-risk endometrial cancer during operation,detection of sentinel lymph node metastases is feasible,but more research with large sample size is needed to determine whether lymphadenectomy with SLN mapping can safely replace systemic lymphadenectomy.
文章编号:     中图分类号:    文献标志码:B
基金项目:国家重点研发计划项目(2018YFC1311300)
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