Ansari M, Rad M A Ghodsi, Hassanzadeh M, Gholami H, Yousefi Z, Dabbagh V R, Sadeghi R
Nuclear Medicine Department, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Nuclear Medicine Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Eur J Gynaecol Oncol. 2013;34(5):387-401.
Sentinel lymph node biopsy is a fairly new approach for staging of gynecological malignancies. In the current study, the authors comprehensively reviewed the available reports on sentinel node biopsy of endometrial cancer.
The authors searched Medline, SCOPUS, ISI web of knowledge, Science Direct, Springer, OVID SP, and Google Scholar with the following search terms: "endometrium OR endometrial OR uterine OR uterus AND sentinel". The outcomes of interest were detection rate and sensitivity.
Overall, 35 studies had enough information for false negative rate evaluation and 51 studies (including the sub-groups of individual studies) for detection rate evaluation (2,071 patients overall). Pooled detection rate was 77.8% (95% CI: 73.5-81.5%) and pooled sensitivity was 89% (95% CI: 83-93%). Cervical injection, as well as using both blue dye and radiotracer, results in higher detection rate and sensitivity. New techniques such as fluorescent dye injection and robotic-assisted surgery showed high detection rate and sensitivity.
Sentinel node mapping is feasible in endometrial cancer. Using both blue dye and radiotracer and cervical injection of the mapping material can optimize the sensitivity and detection rate of this technique. Larger studies are still needed to evaluate the false negative rate and the factors influencing the sensitivity before considering this method safe.
前哨淋巴结活检是一种用于妇科恶性肿瘤分期的相当新的方法。在本研究中，作者全面回顾了关于子宫内膜癌前哨淋巴结活检的现有报告。
作者使用以下检索词在Medline、SCOPUS、ISI知识网络、Science Direct、Springer、OVID SP和谷歌学术上进行检索：“子宫内膜或子宫内膜的或子宫的或子宫与前哨”。感兴趣的结果是检出率和敏感性。
总体而言，35项研究有足够信息用于假阴性率评估，51项研究（包括个别研究的亚组）用于检出率评估（总共2071例患者）。汇总检出率为77.8%（95%CI：73.5 - 81.5%），汇总敏感性为89%（95%CI：83 - 93%）。宫颈注射以及同时使用蓝色染料和放射性示踪剂可提高检出率和敏感性。荧光染料注射和机器人辅助手术等新技术显示出较高的检出率和敏感性。
前哨淋巴结定位在子宫内膜癌中是可行的。同时使用蓝色染料和放射性示踪剂以及宫颈注射定位材料可优化该技术的敏感性和检出率。在认为该方法安全之前，仍需要更大规模的研究来评估假阴性率和影响敏感性的因素。
