Barranger Emmanuel, Cortez Annie, Grahek Dany, Callard Patrice, Uzan Serge, Darai Emile
Department of Gynecologic and Breast Cancers, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, Paris, France.
Ann Surg Oncol. 2004 Mar;11(3):344-9. doi: 10.1245/aso.2004.07.005.
We assessed the feasibility of a laparoscopic sentinel node (SN) procedure based on the combined use of radiocolloid and patent blue labeling in patients with endometrial cancer.
Seventeen patients (median age, 69 years) with endometrial cancer of stage I (16 patients) or stage II (1 patient) underwent a laparoscopic SN procedure based on combined radiocolloid and patent blue injected pericervically. After the SN procedure, all patients underwent complete laparoscopic pelvic lymphadenectomy and either laparoscopically assisted vaginal hysterectomy (16 patients) or laparoscopic radical hysterectomy (1 patient).
SNs (mean number per patient, 2.6; range, 1-4) were identified in 16 (94.1%) of the 17 patients. Macrometastases were detected in three SNs from two patients by hematoxylin and eosin staining. In three other patients, immunohistochemical analysis identified six micrometastatic SNs and one SN containing isolated tumor cells. No false-negative SN results were observed.
An SN procedure based on a combination of radiocolloid and patent blue is feasible in patients with early endometrial cancer. Combined use of laparoscopy and this SN procedure permits minimally invasive management of endometrial cancer.
我们评估了在子宫内膜癌患者中基于放射性胶体和专利蓝联合标记的腹腔镜前哨淋巴结（SN）手术的可行性。
17例子宫内膜癌患者（中位年龄69岁），其中I期16例，II期1例，接受了基于宫颈周围注射放射性胶体和专利蓝的腹腔镜SN手术。SN手术后，所有患者均接受了完整的腹腔镜盆腔淋巴结清扫术，并接受了腹腔镜辅助阴道子宫切除术（16例）或腹腔镜根治性子宫切除术（1例）。
17例患者中有16例（94.1%）识别出了SN（每位患者的平均数量为2.6；范围为1 - 4个）。通过苏木精和伊红染色在两名患者的三个SN中检测到了大转移灶。在另外三名患者中，免疫组织化学分析鉴定出六个微转移SN和一个含有孤立肿瘤细胞的SN。未观察到假阴性SN结果。
基于放射性胶体和专利蓝联合应用的SN手术在早期子宫内膜癌患者中是可行的。腹腔镜检查与该SN手术的联合应用允许对子宫内膜癌进行微创管理。
