Department of Obstetrics and Gynecology, University Hospital of Berne and University of Berne, Effingerstrasse 102, 3010, Bern, Switzerland.
Dipartimento Assistenziale Integrato Ostetricia e Ginecologia, Perinatologia e Puericultura, "Sapienza" University of Rome, Rome, Italy.
J Cancer Res Clin Oncol. 2018 Jul;144(7):1385-1393. doi: 10.1007/s00432-018-2648-y. Epub 2018 Apr 24.
To evaluate the sensitivity, negative predictive value (NPV) and false-negative (FN) rate of the near infrared (NIR) indocyanine green (ICG) sentinel lymph node (SLN) mapping in patients with poorly differentiated endometrial cancer who have undergone a full pelvic and para-aortic lymphadenectomy after SLN mapping.
We performed a retrospective analysis of patients with endometrial cancer undergoing a laparoscopic NIR-ICG SLN mapping followed by a systematic pelvic and para-aortic lymphadenectomy. Inclusion criteria were a grade 3 endometrial cancer or a high-risk histology (papillary serous, clear cell carcinoma, carcinosarcoma, and neuroendocrine carcinoma) and a completion pelvic and para-aortic lymphadenectomy to the renal vessels after SLN mapping. Overall and bilateral detection rates, sensitivity, NPV, and FN rates were calculated.
From December 2012 until January 2017, 42 patients fulfilled inclusion criteria. Overall and bilateral detection rates were 100 and 90.5%, respectively. Overall, 23.8% of the patients had lymph node metastases. In one patient, despite negative bilateral pelvic SLNs, a metastatic non-SLN-isolated para-aortic metastasis was detected. This NSLN was clinically suspicious and sent to frozen section analysis during the surgery. FN rate, sensitivity, and NPV were 10, 90, and 97.1%, respectively. For the SLN mapping algorithm, FN rate, sensitivity, and NPV were 0, 100, and 100%, respectively.
Laparoscopic NIR-ICG SLN mapping in high-risk endometrial cancer patients has acceptable sensitivity, FN rate, and NPV.
评估经全盆腔和腹主动脉淋巴结清扫术（pelvic and para-aortic lymphadenectomy，PALND）后，行近红外吲哚菁绿（near infrared indocyanine green，NIR-ICG）前哨淋巴结（sentinel lymph node，SLN）示踪的低分化子宫内膜癌（endometrial cancer，EC）患者的 SLN 检测的灵敏度、阴性预测值（negative predictive value，NPV）和假阴性（false-negative，FN）率。
我们对行腹腔镜 NIR-ICG SLN 示踪并随后行系统的盆腔和腹主动脉淋巴结清扫术的 EC 患者进行了回顾性分析。纳入标准为 3 级 EC 或高危组织学（乳头状浆液性、透明细胞癌、癌肉瘤和神经内分泌癌）和 SLN 示踪后行完整的盆腔和腹主动脉淋巴结清扫术至肾血管水平。计算总检出率、双侧检出率、灵敏度、NPV 和 FN 率。
2012 年 12 月至 2017 年 1 月，42 例患者符合纳入标准。总检出率和双侧检出率分别为 100%和 90.5%。总体而言，23.8%的患者有淋巴结转移。1 例患者尽管双侧盆腔 SLN 均为阴性，但仍检测到转移性非 SLN-孤立性腹主动脉转移。该 NSLN 在临床上具有可疑性，并在手术中进行了冷冻切片分析。FN 率、灵敏度和 NPV 分别为 10%、90%和 97.1%。对于 SLN 示踪算法，FN 率、灵敏度和 NPV 分别为 0、100%和 100%。
高危 EC 患者的腹腔镜 NIR-ICG SLN 示踪具有可接受的灵敏度、FN 率和 NPV。
