Tangjitgamol S, Manusirivithaya S, Sheanakul C, Leelahakorn S, Sripramote M, Thawaramara T, Kaewpila N
Department of Obstetrics and Gynecology, Bangkok Metropolitan Administration Medical College and Vajira Hospital, Bangkok, Thailand.
Int J Gynecol Cancer. 2003 May-Jun;13(3):297-302. doi: 10.1046/j.1525-1438.2003.13192.x.
This study endeavored to determine whether lymph node size is a reliable indicator in determining lymph node metastasis in common epithelial ovarian cancer. We reviewed pathologic sections of pelvic and para-aortic lymph nodes removed from 104 ovarian carcinoma patients who underwent either primary surgical staging or secondary surgery from January 1994 to July 2001. All sections of each individual node were measured in two dimensions. The different sizes of nodes were studied statistically to determine the optimal sensitivity and specificity in predicting cancer metastasis. A nodal size of 10 mm was a specific point of interest. Of 2069 total nodes obtained, 110 nodes (5.3%) had metastatic cancer. More than half (55.4%) of these positive nodes had a nodal long axis of 10 mm and less. The sensitivity and specificity of nodal size at 10 mm were 44.5% and 81.1%, respectively. We conclude that lymph node size is not a good indicator in determining epithelial ovarian cancer metastasis. Mere sampling of only the enlarged nodes does not reflect the true positive incidence of nodal metastasis. To avoid inaccurate staging and improper management, complete lymph node dissection is proposed as part of surgical staging for ovarian cancer.
本研究旨在确定淋巴结大小是否为判断常见上皮性卵巢癌淋巴结转移的可靠指标。我们回顾了1994年1月至2001年7月期间接受初次手术分期或二次手术的104例卵巢癌患者切除的盆腔及腹主动脉旁淋巴结的病理切片。对每个淋巴结的所有切片进行二维测量。对不同大小的淋巴结进行统计学研究，以确定预测癌症转移的最佳敏感性和特异性。10毫米的淋巴结大小是一个特别关注的点。在总共获得的2069个淋巴结中，110个淋巴结（5.3%）有转移癌。这些阳性淋巴结中超过一半（55.4%）的淋巴结长轴为10毫米或更小。10毫米淋巴结大小的敏感性和特异性分别为44.5%和81.1%。我们得出结论，淋巴结大小并非判断上皮性卵巢癌转移的良好指标。仅对肿大淋巴结进行采样并不能反映淋巴结转移的真实阳性发生率。为避免分期不准确和处理不当，建议将完整的淋巴结清扫作为卵巢癌手术分期的一部分。
