Wydra Dariusz, Sawicki Sambor, Emerich Janusz, Romanowicz Grzegorz
Department of Gynaecology, Medical University, Gdańsk, Poland.
Nucl Med Rev Cent East Eur. 2003;6(2):131-3.
Regional lymph node surgical management is an integral part of cervical cancer therapy. In gynaecological oncology, recent studies have confirmed the utility of the sentinel node concept in vulvar and cervical cancer. The method of the marker's administration is considered to play an important role in sentinel node detection.
60 patients with cervical cancer (stage IB-IIA) underwent SLN detection during radical abdominal hysterectomy. The patients were randomly divided into two groups: the first group of 30 patients with 0.5-1cm deep marker injection, the second with sub-epithelial marker injection. Gamma-camera scanning, as well as hand-held probe detection was applied.
All hot nodes visualised on lymphoscintigraphy were "hot" when using the hand-held gamma probe. Deep marker injection revealed a sentinel node in 27 patients (90%) on both sides, in 3 patients (10%) only on one side. Only 40 (67%) sentinel nodes were blue-stained. Sub-epithelial marker administration revealed a sentinel node on both sides in all 30 patients (100%). In 28 patients (93.3%) the sentinel nodes were radioactive and blue-stained, in one case not-blue stained on either side, in one case blue stained only on one side.
The sentinel node detection rate in cervical cancer is relatively high and depends on the applied technique. The superficial administration of radiocolloid and the blue dye into the cervix provides a higher sentinel node detection rate than deep administration in cervical cancer patients.
区域淋巴结手术管理是宫颈癌治疗的一个组成部分。在妇科肿瘤学中，最近的研究证实了前哨淋巴结概念在外阴癌和宫颈癌中的实用性。标记物的给药方法被认为在前哨淋巴结检测中起着重要作用。
60例宫颈癌患者（IB-IIA期）在根治性腹式子宫切除术中进行前哨淋巴结检测。患者被随机分为两组：第一组30例患者进行0.5-1cm深度的标记物注射，第二组进行上皮下标记物注射。应用γ相机扫描以及手持探头检测。
当使用手持γ探头时，淋巴闪烁显像中所有显影的热结节均为“热”结节。深度标记物注射显示，27例患者（90%）双侧均有前哨淋巴结，3例患者（10%）仅一侧有前哨淋巴结。仅40个（67%）前哨淋巴结有蓝色染色。上皮下标记物给药显示，所有30例患者（100%）双侧均有前哨淋巴结。28例患者（93.3%）的前哨淋巴结有放射性且呈蓝色染色，1例患者双侧均无蓝色染色，1例患者仅一侧有蓝色染色。
宫颈癌前哨淋巴结检测率相对较高，且取决于所应用的技术。在宫颈癌患者中，将放射性胶体和蓝色染料浅表注入宫颈比深部注入能提供更高的前哨淋巴结检测率。
