UMRS 872, Centre de Recherche des Cordeliers, 15 rue de l'école de médecine, 75006 Paris, France.
Gynecol Oncol. 2013 Dec;131(3):708-13. doi: 10.1016/j.ygyno.2013.10.006. Epub 2013 Oct 11.
Our objective was to concomitantly assess distribution of lymphatic and nerve structures in the parametrium.
Twenty hemipelvises from ten fresh cadavers were dissected to differentiate between, three different parts of the parametrium: the lateral parametrium, the proximal and the distal part of the posterior parametrium. Histologic and immunofluorescence analyses of nerve and lymphatic structures were performed using NSE and LYVE-1 staining, respectively. The percentage of structures was independently scored as 0 (0%), 1 (1-20%), 2 (20-50%), 3 (50-80%), 4 (>80%).
The lateral parametrium and the proximal part of the posterior parametrium contained both nerve (scored 2.25 and 2.50, respectively) and lymphatic (scored 2.50 and 2.00, respectively) structures. The distal part of the posterior parametrium also contained numerous nerve structures (scored 2.00) but lymphatic structures were rare (scored 0.88). No difference in nerve distribution was found according to the parts of parametrium while a significantly lower distribution of lymphatic vessels was observed in the distal part of the posterior parametrium (p=0.03).
The distal part of the posterior parametrium is of high nerve density and low lymphatic density raising the issue as to whether it should be removed during radical hysterectomy.
我们的目的是同时评估淋巴管和神经结构在宫旁组织中的分布。
从十个新鲜尸体的二十个半骨盆中进行解剖，以区分宫旁组织的三个不同部分：侧宫旁组织、后宫旁组织的近侧和远侧部分。使用 NSE 和 LYVE-1 染色分别对神经和淋巴管结构进行组织学和免疫荧光分析。结构的百分比独立评分 0（0%）、1（1-20%）、2（20-50%）、3（50-80%）、4（>80%）。
侧宫旁组织和后宫旁组织的近侧部分均含有神经（分别评分为 2.25 和 2.50）和淋巴管（分别评分为 2.50 和 2.00）结构。后宫旁组织的远侧部分也含有大量神经结构（评分为 2.00），但淋巴管结构很少（评分为 0.88）。神经分布在宫旁组织的不同部位没有差异，而在后宫旁组织的远侧部分淋巴管的分布明显较低（p=0.03）。
后宫旁组织的远侧部分神经密度高，淋巴管密度低，这引发了一个问题，即在根治性子宫切除术时是否应该切除该部位。
