Pelosi E, Arena V, Baudino B, Bellò M, Giusti M, Gargiulo T, Palladin D, Bisi G
Servizio di Medicina Nucleare Universitaria, Ospedale S. Giovanni Battista, Torino, Italy.
Nucl Med Commun. 2003 Sep;24(9):971-5. doi: 10.1097/00006231-200309000-00005.
Lymphatic mapping and sentinel lymph node (SLN) biopsy are becoming increasingly useful for the identification of tumour lymphatic spread in a wide variety of neoplasms, such as breast cancer and melanoma, reducing unnecessary radical lymph node resection. The aim of our study was to determine the feasibility of lymphatic mapping with both labelled colloid and patent blue violet in patients with early stage endometrial cancer. Sixteen consecutive patients with endometrial cancer, stage International Federation of Gynecology and Obstetrics (FIGO Ib), were included in the study. Lymphoscintigraphy and laparoscopically assisted intra-operative SLN detection were performed in all patients. In addition, to verify the prognostic role of this method, 12 of 16 patients were followed up for a period of at least 1 year. In 15 of 16 patients, 24 SLNs (all internal iliac lymph nodes) were detected at lymphoscintigraphy (six monolateral and nine bilateral). At histological analysis, three of the 24 were positive for micrometastases, whereas the remaining 21 were negative. No other surgically dissected lymph nodes presented metastases. At 1 year of follow-up, none of the 12 patients presented relapse of their disease. In conclusion, in endometrial cancer, both pre-operative lymphoscintigraphy and intra-operative gamma-probe detection of SLNs represent promising tools for the visualization of SLNs. The status of the latter may yield a correct representation of pelvic lymph node involvement, providing important information for further treatment.
淋巴绘图和前哨淋巴结（SLN）活检在识别多种肿瘤（如乳腺癌和黑色素瘤）的肿瘤淋巴转移方面正变得越来越有用，减少了不必要的根治性淋巴结切除术。我们研究的目的是确定在早期子宫内膜癌患者中使用标记胶体和专利蓝紫进行淋巴绘图的可行性。本研究纳入了连续16例国际妇产科联盟（FIGO）Ib期子宫内膜癌患者。对所有患者进行了淋巴闪烁显像和腹腔镜辅助术中SLN检测。此外，为了验证该方法的预后作用，对16例患者中的12例进行了至少1年的随访。在16例患者中的15例中，淋巴闪烁显像检测到24个SLN（均为髂内淋巴结）（6个单侧和9个双侧）。组织学分析显示，24个中有3个微转移呈阳性，其余21个为阴性。没有其他手术切除的淋巴结出现转移。随访1年时，12例患者均未出现疾病复发。总之，在子宫内膜癌中，术前淋巴闪烁显像和术中γ探针检测SLN都是可视化SLN的有前景的工具。后者的状态可能正确反映盆腔淋巴结受累情况，为进一步治疗提供重要信息。
