van der Poel H G, Meershoek P, Grivas N, KleinJan G, van Leeuwen F W B, Horenblas S
Department of Urology, Netherlands Cancer Institute, Plesmanlaan 121, 1066CX, Amsterdam, The Netherlands.
Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.
Urologe A. 2017 Jan;56(1):13-17. doi: 10.1007/s00120-016-0270-7.
Nodal metastases are linked to poor outcome in men with penile or prostate cancer. Early detection and resection are important for staging and for the prognosis. However, lymphadenectomy is associated with morbidity and may miss metastases when performed solely on the basis of anatomical templates.
In this article we describe the technique and benefits of sentinel node biopsy (SNB) and provide a review of the literature.
Dynamic sentinel node techniques using both radioactive and optical (hybrid) tracers have been proven effective in penile cancer. For prostate cancer, SNB added to extended nodal dissection may further tailor dissection to the highly variable lymphatic drainage patterns in the pelvis. The sensitivity of SNB was found to be superior to conventional imaging methods; however, false-negative SNB procedures can occur and a complementary extensive lymphadenectomy is required to remove additional positive nodes that were not detected in the SNB template.
SNB is a standard method for early detection of nodal metastases in penile cancer and provides superior diagnostic accuracy to conventional imaging modalities in prostate cancer.
淋巴结转移与阴茎癌或前列腺癌男性患者的不良预后相关。早期检测和切除对于分期及预后至关重要。然而，淋巴结清扫术会带来并发症，且仅基于解剖模板进行操作时可能会遗漏转移灶。
在本文中，我们描述了前哨淋巴结活检（SNB）的技术及优势，并对相关文献进行综述。
使用放射性和光学（混合）示踪剂的动态前哨淋巴结技术已被证明在阴茎癌中有效。对于前列腺癌，在前哨淋巴结活检基础上增加扩大淋巴结清扫术，可根据盆腔中高度可变的淋巴引流模式进一步调整清扫范围。前哨淋巴结活检的敏感性优于传统成像方法；然而，可能会出现前哨淋巴结活检假阴性情况，因此需要进行补充性广泛淋巴结清扫术以清除在前哨淋巴结活检模板中未检测到的其他阳性淋巴结。
前哨淋巴结活检是阴茎癌淋巴结转移早期检测的标准方法，在前列腺癌中其诊断准确性优于传统成像方式。
