Rodier J F, Janser J C, Navarrete E, Rodier D
Département de Chirurgie Cancérologique, Centre Paul Strauss, Strasbourg.
J Chir (Paris). 1989 May;126(5):319-26.
Despite coded staging of localization studies in cancer of the uterine cervix, numerous authors have attempted to improve knowledge concerning certain prognostic factors, of which the most important in lymph node status. It is with this in view that pre-scalene biopsies are performed. Their adjunction to pretreatment investigations appears to be determining, especially in advanced-stage forms when aggressive surgical (pelvic exenteration), radiation (lomboaortic irradiation) or even chemotherapeutic treatments are being considered. Because of the wide variation in the results in the literature and the lack of precision of the indications of this low-morbidity surgical procedure, the authors decided to define the place of this supraclavicular lymph node investigation for staging. While it need not be systematic in the early stages of the disease, this does not seem to be the case in advanced stages and recurrences which call for a more moderate attitude.
尽管子宫颈癌的定位研究有编码分期,但众多作者仍试图增进对某些预后因素的了解,其中淋巴结状态最为重要。正是出于这一考虑才进行前斜角肌活检。其在预处理检查中的辅助作用似乎具有决定性意义,尤其是在考虑进行积极的手术(盆腔脏器清除术)、放疗(腰主动脉照射)甚至化疗的晚期病例中。由于文献报道结果差异很大,且这种低发病率手术的指征不够精确,作者决定明确这种锁骨上淋巴结检查在分期中的地位。虽然在疾病早期不必进行常规检查,但在晚期病例和复发情况中似乎并非如此,此时需要采取更为适度的态度。