Bats Anne-Sophie, Clément Denys, Larousserie Florence, Le Frère-Belda Marie-Aude, Pierquet-Ghazzar Nadia, Hignette Chantal, Lécuru Fabrice
Service de Chirurgie Gynécologique et Cancérologique, Hôpital Européen Georges Pompidou, Paris, France.
J Surg Oncol. 2008 Feb 1;97(2):141-5. doi: 10.1002/jso.20857.
To map sentinel lymph nodes (SLNs) detected by intracervical injection in patients with endometrial cancer and to determine the prevalence of node micrometastases.
Radionuclide and blue dye injections were used for SLN detection in 43 patients with clinical stage I endometrial cancer. Lymphoscintigraphy was done before surgery. Intraoperatively, the pelvic and para-aortic territories were examined for blue and/or radioactive nodes. Pelvic lymphadenectomy was performed with or without para-aortic lymphadenectomy. SLNs stained with hematoxylin-eosin-saffron were examined and, when negative, evaluated using step sectioning and immunohistochemistry.
Feasibility was 100%. No adverse effects occurred. SLNs were identified in 30 patients (69.8%), usually in an interiliac location (28/30 patients, 93.3%). SLNs were found only in the common iliac chain in 1 (3%) patient and in both the common iliac chain and promontory area in another (3%). No patients had para-aortic SLNs or SLNs confined to the promontory. Node metastases were identified in eight patients and were confined to SLNs in six. In 2 (2/30, 6%) patients, SLNs contained micrometastases. No false-negatives occurred.
Intracervical injection of radionuclide and blue dye chiefly revealed pelvic SLNs. The prevalence of micrometastases was within the expected range. Comparisons with peritumoral injection are needed.
对子宫内膜癌患者经宫颈注射检测前哨淋巴结（SLN）并确定淋巴结微转移的发生率。
对43例临床I期子宫内膜癌患者采用放射性核素和蓝色染料注射法检测SLN。术前进行淋巴闪烁显像。术中检查盆腔和腹主动脉旁区域有无蓝色和/或放射性淋巴结。行盆腔淋巴结清扫术，可同时或不同时行腹主动脉旁淋巴结清扫术。对苏木精-伊红-番红染色的SLN进行检查，若为阴性，则采用连续切片和免疫组化进行评估。
可行性为100%。未发生不良反应。30例患者（69.8%）检测到SLN，通常位于髂间位置（28/30例患者，93.3%）。仅1例（3%）患者的SLN仅位于髂总链，另1例（3%）患者的SLN位于髂总链和岬部区域。无患者有腹主动脉旁SLN或仅局限于岬部的SLN。8例患者发现有淋巴结转移，其中6例局限于SLN。2例（2/30，6%）患者的SLN含有微转移。未出现假阴性结果。
经宫颈注射放射性核素和蓝色染料主要发现盆腔SLN。微转移的发生率在预期范围内。需要与肿瘤周围注射法进行比较。
